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CMS says payers must provide data to support value-based care


As the Centers for Medicare & Medicaid Services accelerates the move a value-based payment model, its efforts are dependent upon receiving data from health insurers to improve care delivery, says CMS Acting Administrator Andy Slavitt, according to an article from Health Data Management.

The goal of a value-based system is to cut down on the volume of unnecessary procedures while improving patient outcomes. This is not designed to pit providers against payers, but instead, have the two entities work together in order to provide the best care possible, Slavitt said Tuesday at the 2015 CMS Quality Conference in Baltimore. Thus, payers need to support providers in improving the entirety of their practice, or delivery system reform won't succeed.

Slavitt made the case that business practices, not technology, hold back the healthcare industry, particularly when it comes to health information blocking. Some providers who participate in alternative payment models have said health plans refused to provide them with data, or the data plans provide won't integrate with their systems, Slavitt said. Soon, though, EHRs will be required to have open application program interfaces that will enable developers to build apps in order to safely connect the data, he added.

In September, Blue Cross Blue Shield announced the launch of a massive database that would make information regarding healthcare quality and cost available to employers, members and provider partners. But CMS will require commercial health plans that do business in the Affordable Care Act marketplace and in Medicare to make data that is valuable to providers or patients available in machine-readable form, according to Slavitt.

To learn more:
- read the Health Data Management article

Related Articles:
Feds speed plans for value-based payments
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To engage payers, HIEs must better meet their needs
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