April 2, 2015

Comprehensive Health Care Payment Reform: What Will it Take to Get There?

Last month Secretary Sylvia Mathews Burrell announced that HHS has adopted a goal of shifting half of Medicare payments from traditional fee-for-service to an alternative method by 2018. Despite many new Affordable Care Act initiatives, progress on payment reform around the country has been spotty. Most of the new payment initiatives provide financial incentives for quality or reward provider groups that control total spending below a budget target. But most of these programs place little financial risk on providers. It is not known whether these limited financial incentives are strong enough to drive meaningful delivery reforms nor is it known whether they will evolve into stronger arrangements.

This Health Industry Forum meeting will examine what needs to be done to wean the U.S. health system off fee-for-service and whether this is an achievable goal over the next decade. We will present results from a new survey of medical group risk contracting practices that analyzes changes that have occurred as ACA payment and delivery reforms have been rolled out. It will look at specific providers that have increased the proportion of their business in risk contracts rapidly and the lessons that other groups can take from these experiences. It will then examine the potential for provider partnerships with health plans to accelerate risk sharing and build provider capacity to manage care effectively. The forum will conclude with a discussion among leading policy officials with their prognoses for the success of comprehensive payment reform.

Agenda

Participants