Of $360 million in Medicare fee-for-service (FFS) payments in 2013, 42 percent were value-based, according to an independent scorecard from nonprofit Catalyst for Payment Reform (CPR).
CPR used a multi-stakeholder advisory committee back in August 2014 to analyze results from 2013. The scorecard measures total dollars paid--not just the incentive portion. The report excludes Medicare Parts C and D.
Here's how CPR broke down its findings:
Fifty-eight percent of traditional FFS payments did not include incentive to improve quality and reduce waste.
For the 42 percent that were value-oriented, about 33 percent of Medicare payments were made through pay-for-performance programs, about 12 percent were made through Medicare shared savings programs (MSSP) and nearly 2 percent were made through shared risk programs.
Nearly 15 percent of Medicare FFS beneficiaries were attributed to MSSP or the Pioneer ACO program, which launched in 2013.
Nearly 18 percent of FFS hospital admissions were readmissions--down from 19 percent in 2011.
"The goal of the scorecard was to quantify the percentage of FFS Medicare dollars present in U.S. healthcare that is subject to some form of value-oriented payment regimes," CPR Executive Director Suzanne Delbanco said during a phone presentation on the results this morning.
The big takeaway is that there's tremendous momentum toward value. However, it's important to keep in mind that most of these methods are based on FFS models, CPR's Program Director Andréa Caballero, who led this research, noted during the call.
The findings align with the Centers for Medicare & Medicaid Services' announcement earlier this year that the agency will tie 30 percent of all FFS payments to providers to quality initiatives through alternative payment models--particularly accountable care organizations (ACOs) and bundled payments--by 2016. It will rise to 50 percent by 2018.
- here's the scorecard