ACHP: Reaction to Introduction of Bipartisan Medicare Payment-for-Performance Legislation

WASHINGTON, D.C. Jack Ebeler, president and CEO of the Alliance of Community Health Plans (ACHP), issued the following statement today in reaction to the introduction of bipartisan Medicare payment-for-performance legislation by Senate Finance Committee Chairman Chuck Grassley (R-IA) and Ranking Member Max Baucus (D-MT):

“For years, ACHP members have measured the quality of the health care they provide and shared the results with providers and the public.  Many of our members already use similar information to reward providers who deliver high-quality care or improve from one year to the next.  We commend Chairman Grassley and Senator Baucus for working across party lines to make Medicare accountable to quality by paying more for better care. 

“We are pleased that the bill’s incentives apply to all Medicare providers and that the incentives are based on standards of excellence and improvement.  We are also pleased that quality measures will stress clinical performance.  However, the bill’s funding mechanism poses a significant barrier to successful implementation and long-term sustainability.

“As America’s biggest payer, Medicare should lead the effort to align payments with quality.  As the legislative process progresses, ACHP welcomes the opportunity to work with Congress to encourage better care for all beneficiaries.”

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ACHP’s Payment-for-Performance Principles: 

  • Payment-for-performance incentives should eventually apply to all Medicare providers, including fee-for-service and Medicare Advantage. Given health plans long record of reporting on standardized measures of quality, it is reasonable to begin with Medicare Advantage plans, including HMOs and PPOs.
  • Pay-for-performance incentives should be based upon standards of excellence and improvement.
  • Measures to evaluate both fee-for-service Medicare and Medicare Advantage plans should be developed. In the interim, incentives should be based on existing measures and should emphasize clinical effectiveness.
  • To ensure successful implementation and sustainability, pay-for-performance incentives should be financed with a new, dedicated stream of funding.

 

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The Alliance of Community Health Plans brings together innovative health plans and provider organizations that are among America’s best at delivering affordable, high-quality coverage and care to their communities.  Drawing on years of experience, members collaborate to identify problems, share information and work toward solutions to some of health care’s biggest challenges.  Their work is the foundation for ACHP’s advocacy on behalf of better health care nationally.  More information is available at www.achp.org.

Capital Health Plan; CareOregon; Fallon Community Health Plan; Group Health Cooperative; Group Health Cooperative of South Central Wisconsin; Health Alliance Plan; HealthPartners; HIP Health Plan of New York; Kaiser Foundation Health Plans and the Permanente Federation; M•Plan; OSF HealthPlans; UCare Minnesota; UPMC Health Plan