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Payers positioned to lead alternative payment model transformation

Highmark, Capital BlueCross execs share what steps they're taking to implement paying for value instead of volume

Back in January, when the Department of Health and Human Services (HHS) announced it would fundamentally reform how it pays providers for treating Medicare patients, industry reaction was mixed. While the payer community appeared, for the most part, receptive to the change, the provider community wanted to take a more cautious approach as it waited for more information from HHS.

Amid the announcement, the Centers for Medicare & Medicaid Services (CMS) said it will tie 30 percent of all fee-for-service payments to providers to quality initiatives through alternative payment models by 2016, and 50 percent by 2018, as FierceHealthFinance previously reported.

Change is scary--there's the whole, embarking-into-the-unknown and what-will-happen mentality that typically comes into play--but it doesn't have to be. Solid preparation and a game plan can help ease the transition--but, industry-wide, all entities need to get on board.

Payers have been implementing alternative payment methods for years, so they are well positioned to take the reigns and work with providers and the industry to make CMS' goal a reality. FierceHealthPayer spoke with three industry executives at two different insurers about what they're doing to shift away from emphasizing paying for volume and, instead, paying for value.