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40% of provider reimbursements are for value-based care


Demonstrating a dramatic move toward value-based payment, 40 percent of insurers' reimbursements to providers are for value-based care that improves quality and reduces waste--an increase of 29 percent from 2013, according to a new report from Catalyst for Payment Reform.

The report, which is a scorecard based on data representing almost 65 percent of commercial health plans across the country, shows that traditional fee-for-service payment "may rapidly be becoming a relic," Suzanne Delbanco, CPR's executive director, wrote in a Health Affairs blog post.

CPR also found that 15 percent of insurers' members, up from 2 percent last year, are formally attributed to a provider who is participating in value-based contract, including accountable care organizations and patient-centered medical homes.

However, CPR doesn't see that large jump in value-based payment as an all-around good thing. "With today's pressure to reform payment, health plans and providers are building on a method they know, despite limited evidence it improves care or saves money," Andréa Caballero, CPR's program director, said in a statement. "If we hope to see advances in quality and affordability in the long-term, payers may need to take payment methods to the next level, pairing bonuses with financial risk to providers."

CPR noted, for example, that a mere 0.1 percent of the value-based reimbursements are bundled payments, even though that model "has probably the most promise," Caballero told FierceHealthPayer in a previous interview.

What's more, value-based payments are only effective if they actually lower costs and improve quality care. But there's no real evidence showing those results yet, Delbanco noted in her blog post.

To learn more:
- here's the CPR statement and report
- read the Health Affairs blog

Related Articles:
How to build a successful bundled payment program
Roadblocks for implementing value-based healthcare
Reimbursement system is broken, insurance CEO says
Kaiser Permanente's Jack Cochran on the path to value-based care
Change provider behavior to achieve pay-for-performance success