HHS Secretary Alex Azar has outlined four of his biggest priorities for the department.
Perhaps surprising some providers, Azar told the Federation of American Hospitals on Monday that there would be “no going back to a system that pays for procedures rather than value,” and asserted that the Trump administration doesn’t fear disrupting current arrangements, regardless of the powerful economic interests backing them. Sounds like someone from the Obama administration….
He also suggested a willingness to have “perhaps even an uncomfortable degree” of federal intervention to make the system work better for the stakeholders he sees as least well-served currently: patients and taxpayers, FierceHealthcare reported.
His priorities for accelerating the move toward a value-based healthcare sector, as summarized by Fierce:
“1. Moving ownership and control of electronic health records from providers to patients.”
“2. Providing payers and providers with incentives to be more transparent about healthcare costs.”
“3. Using Medicare and Medicaid to drive industry change.”
He called previous efforts to drive innovation such as through Affordable Care Organizations “lackluster,” promising “bold measures” to “create a true competitive playing field where value is rewarded handsomely.”
“4. Reducing regulatory burdens.”
“He particularly singled out reporting rules and FDA policies around communications that he said might inhibit collaboration among stakeholders.”
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California Gov. Jerry Brown has backed spending more money for value-based payment initiatives and behavioral-health programs in the state’s Medicaid program and also wants to spend more money on covering healthcare expenses of immigrant children up to age 19 who are in the United States illegally.
Still, despite modest increases in funding for Medi-Cal, the state’s Medicaid program, patient advocates complained that the revisions do little to restore $15 billion in cuts made during the Great Recession and its aftermath.
Bruce Japsen writes in Forbes that:
“News that one of the nation’s largest health-insurance companies is pursuing an evidence-based approach to substance abuse treatment and opioid addiction could potentially speed up the slow march away from fee-for-service mental-health treatment.
“But Cigna CI +0.33% and other health insurers that escalate their shift to value-based payments could reap a potential bonanza by reimbursing psychiatrists and other mental- health providers based on how they improve the care of their patients, mental-health advocates say.”
An article in JAMA asserts that “valued-based payments require valuing what matters to patients.”
The authors conclude:
“As Medicare moves to implement value-based payment initiatives tied only to current quality measures, the values of large populations of disabled and frail persons, whose care is the most costly and most concentrated in Medicare, are at high risk for being seriously neglected. These people will receive the medications and treatments that would be mostly correct if they were healthier, but their actual priorities will be neither noticed nor met. If the United States intends to pay on the basis of value, it is essential to ask patients what they value, and then deliver on those priorities.