Payment-for Performance in Medicare Should Begin With Health Plans
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 Medicare Payment Advisory Commission’s (MedPAC) March report to Congress: “The quality of care that Medicare beneficiaries receive varies significantly from plan to plan and provider to provider, yet we continue to pay excellent- and poor-performers at the same levels.
“We commend MedPAC for again recommending that Congress retool the payment system in Medicare to provide incentives for the highest quality care and improvements in quality.
“All Medicare providers should eventually be included in a pay-for-performance program, but Medicare should begin with Medicare Advantage plans. These plans have a long history of reporting quality information to the public and have the capacity to use payment incentives to drive quality improvement.”
ACHP’s four principles for payment-for-performance appear below:
- 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; Excellus; 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