While CMS may have only recently heard the concerns of the provider community regarding successful value-based payment model participation, HIMSS has already begun activities to design resources that will allow its members to successfully transition from fee-for-service to pay-for-value.
The litmus test for overwhelming public consternation regarding Centers for Medicare and Medicaid Services’ (CMS) proposed rule on the Medicare Access and CHIP Reauthorization Act (MACRA) must have shone brightly for CMS’ Andy Slavitt to suddenly announce in a blog that providers can pick their pace of participation in the quality performance program for the first performance period that begins January 1, 2017. His blog identifies four options for quality performance program participation that assure providers do not receive a negative payment adjustment in 2019. The blog identifies November 1 as the date by which the final rule that will contain more detail on the options will be published.
While CMS may have only recently heard the concerns of the provider community regarding successful value-based payment model participation, HIMSS has already begun activities to design resources that will allow its members to successfully transition from fee-for-service to pay-for-value. These activities are partly a response to a 2015 HIMSS Healthcare Cost Accounting Survey that revealed while 50 percent of respondents already participate in an alternative payment model, only 3 percent believe their organizations are equipped to make the change. The survey also revealed healthcare providers and delivery systems yearn for sound business processes and tools necessary to build the technical infrastructure necessary to facilitate the transition.
One HIMSS activity designed to address the respondents identified needs involves the inception of a task force composed of a cross-section of industry thought leaders from all major stakeholder groups, including financial services, health plans, consultants, industry associations, government offices, technology providers in concert with a stakeholder group of healthcare providers. The task force, called the HIMSS APM Infrastructure Task Force is charged with developing and socializing an administrative framework for alternative payment models, deliver educational sessions, publish thought leadership articles as well as gauge industry readiness for pay-for-value.
The HIMSS APM Infrastructure Task Force’s 2017 deliverables will provide resources necessary for a pay-for-value transition. The Task Force will:
- Deliver HIMSS17 pre-conference symposium proposal, “Operating in a Value-Based World”
- Develop and socialize a proposal for administrative framework for alternative payment models. Process will include:
- Identify prioritized list of components, including those required for an effective cost accounting system
- Develop definition and explanation of importance of each component
- Recognize which components will require national standards and/or uniform operating rules
- Coordinate activities with national efforts such as ACLC, HCP LAN and the Health Care Transformation Task Force
- Deliver no fewer than 3 podcasts or webinars focused on specific components of the administrative infrastructure required to support alternative payment models
The HIMSS APM Infrastructure Task Force’s 2017 deliverables are designed to address many of the gaps identified by providers in the HIMSS Healthcare Cost Accounting Survey. They will provide the underpinnings of an administrative infrastructure upon which providers can best be positioned to excel in pay-for-value payment systems. If you are interested in joining the APM-I Task Force, please contact Pam Jodock.
About the author:
In her role as CEO, Rene oversees all Federally Qualified Health Center activities related to system interoperability and health information exchange formation. Rene is responsible for oversight of all federal HCCN grant activities as a contractor to the Virginia Primary Care Association. Rene is a former CMS, Office of General Counsel attorney and is currently a member of the National Rural Health and Human Services Advisory Committee.