CMS is Ahead of Schedule…Are You?

CMS log blueBy: Valerie Shahriari

It’s only 2015 and CMS has already reached 42% of their 50% goal to tie traditional Medicare payments to quality or value by 2018. Humana has implemented a similar strategy and set a 50% goal by 2018 and Aetna further has upped the ante by striving to tie a whopping 75% of Medicare Advantage members to ACOs by 2017!

It’s clear the tide is moving from Fee for Service to Value Based Payments, and the goals of value based programs have been spelled out for us: Better Health for the Population, Better Care for Individuals, and Lower Cost through improvement. What does that mean? It means that your practice must now learn to bend both the quality AND cost curve. But where to start?

Before you even consider entering in to an agreement,

  1. Metrics for both the quality and cost curve must be established;
  2. A baseline assessment of your practice for applicable quality measures must be completed; and
  3. A plan for improvement should be drafted so that your impact has a path.

Only once you are prepared can you begin to devise contracting strategies that capture the strength of your practice.

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