In a letter to President Donald Trump and Vice President Mike Pence, a group of healthcare organizations today called for renewed efforts to transform the healthcare system from fee-for-service payment models to those based on value and quality outcomes.
"On behalf of the nation's leading clinicians, employers, hospitals, biopharmaceutical companies, pharmacists, patients, consumer groups and insurance providers, we are writing to underscore our commitment to advancing the highest quality, most cost-effective healthcare system in the world," the letter says. "We call upon Congress and the Trump Administration to help us achieve this goal."
As congressional Republicans work to devise a plan to replace the ACA, the authors of the letter urge lawmakers to build on gains made in the transformation to pay-for-performance models.
"Through private and public sector alignment, the move toward value-based care is succeeding, measurably improving healthcare quality and contributing to historically low costs," the letter says. "Now is not the time for policymakers to signal a shift away from value-based care, either through action or inaction."
As policymakers debate the direction of federal healthcare policy, signers of the letter put forth 10 recommended principles to help build momentum behind and align incentives with value-based care.
The 10 principles include:
1. Empower and engage patients to make healthcare decisions with information and support from their healthcare team.
2. Invest in engaging patients in the development of measures of provider performance that are relevant to them and consistently and transparently reported by all public and private payers.
3. Improve clinician and provider access to timely, accurate and complete claims data to better facilitate care management.
4. Recognize that the socioeconomic status of many patients creates challenges in providing care, and adjust payments to providers as appropriate.
5. Design voluntary payment models that incent greater participation and achieve the highest quality and cost value based on patient choice and competitive markets.
6. Expand the use of waivers from fee-for-service legal and regulatory requirements that impede collaboration and shared accountability, while preserving consumer protections and safeguards against fraud.
7. Build on and expand payment models that promote collaborative financial and care coordination arrangements using incentives that align payers, healthcare providers, providers of long-term care services and clinicians.
8. Appropriately incent access to medical innovations and treatments that hold the potential to improve quality of care and reduce overall system cost.
9. Promote public and private investment in the transparent, evidence-based testing and scaling of new alternative payment models as directed in the Medicare Access and CHIP Reauthorization Act so that clinicians, other healthcare providers and payers can learn how payment models work and evolve in the clinical setting.
10. Ensure alignment between private and public sector programs, which is critical to a sustainable value-based payment marketplace.