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Comments from Experts on Life Span of Value-Based Payment Models

Many questions have arisen about the future of the Affordable Care Act (ACA) since the election. From providers’ point of view, iProtean, now part of Veralon expert and Veralon Managing Director and CEO Dan Grauman noted the “repeal” of ACA probably will not eliminate alternative payment models (ACOs, bundled payments, etc.).


Grauman noted in a recent update that shifting to value-based care has bi-partisan support, compared to individual and employer mandates, exchanges, insurance industry regulations, Medicaid expansion and taxes to pay for these, the focus of the repeal efforts to date.


It would be difficult to undo some aspects of the ACA without disassembling the Medicare Access and CHIP Reauthorization Act (MACRA), which received bipartisan support. And the Center for Medicare & Medicaid Innovation (CMMI), created by the ACA and targeted for elimination by some Republican lawmakers, provided the advanced alternative payment models used by MACRA. (“Trump Victory Fires Speculation About Physician Pay Reform,” HFMA Weekly, November 11, 2016)


An executive from the American College of Physicians noted in a recent interview that without CMMI, the alternative payment side of MACRA wouldn’t work. He noted that MACRA “will keep driving healthcare transformation from volume- to value-based payments, regardless of efforts to undo the ACA. “Of all the things I could be concerned about, the movement to more value-based payment is not one that I see as under threat. They’re going to need to find cost savings without compromising quality. That’s a constant.” (“Trump Victory Fires Speculation About Physician Pay Reform,” HFMA Weekly, November 11, 2016)


However, the move toward physician practice consolidation could change, according to health policy experts. Changes could include easing the administrative and bureaucratic burdens physicians face, instituting medical liability reforms, and altering the movement toward value-based payments. (“Trump Victory Fires Speculation About Physician Pay Reform,” HFMA Weekly, November 11, 2016)



iProtean, now part of Veralon subscribers, the advanced Governance course, Governance in an Era of Population Health, featuring Jim Rice, Karma Bass and Marian Jennings is now in your library. These experts discuss the implications of population health management for governing boards, governing across boundaries and how to prepare for population health initiatives.


And coming soon, Driving a Culture of Quality, What Works, What Doesn’t, featuring Larry McEvoy, M.D., and Stephen Beeson, M.D.



For a complete list of iProtean, now part of Veralon courses, click here.



For more information about iProtean, now part of Veralon, click here.