By Casey Korba, Director of Policy

The second annual Health Care Value Week, held virtually last month, provided Aledade with an opportunity to celebrate the progress made in value-based care while continuing to discuss the evolving value-based health care landscape with our fellow travelers and policymakers.

Center for Medicare and Medicaid Innovation (CMMI) plans to roll out new models based on lessons learned

Liz Fowler, Director of the Center for Medicare and Medicaid Innovation, announced upcoming new payment models this year, including one for Advanced Primary Care (APC) and an additional model that would enable states to assume the total cost of care for Medicare. Efforts are underway to make it possible for more safety-net providers to participate in CMMI models and to increase specialist participation. The proposed state-enabled Medicare payment model will share similarities with the Maryland Total Cost of Care Model, which has been shown to generate savings. Furthermore, CMMI is committed to advancing health equity, with Fowler indicating that equity design elements within ACO REACH are being examined with the intent to scale progress.

Fowler provided a wrap-up of the week, reiterating that the move toward accountable care is the cornerstone of CMMI’s strategy. Looking ahead to the rest of the year, she discussed her excitement about launching the new payment models and increased engagement with beneficiaries. Through this increased engagement, Fowler hopes to build community trust and broaden the understanding of value-based, accountable care for patients.

Learning from 10 years of the Medicare Shared Savings Program (MSSP) –and what’s ahead

Aledade’s Chief Policy Officer, Sean Cavanaugh, participated in a panel during Health Care Value Week. This panel included Doug Jacobs, Chief Transformation Officer for the Center for Medicare and Medicaid Services (CMS), and others from the Medicare Payment Advisory Commission and health system ACOs. Notably, Jacobs spoke about the successes of the MSSP, including saving Medicare more than $6 billion in the last five years while delivering high-quality care. He acknowledged that the program needs refinement as CMS works towards the goal of having all beneficiaries in accountable care arrangements by 2030. Some of the current challenges facing the program include plateauing participation numbers, accessibility for underserved minority populations, and the ratchet effect resulting in some successful ACOs having their benchmarks reduced. However, recent changes in the 2023 Physician Fee Schedule (PFS) will provide a clearer path forward.