Payment and Reimbursement: Learning from Experience

Navigant's Rich Bajner Comments on Value-Based Care in HFMA

Even before the Medicare Access and Chip Reauthorization Act of 2015 became law, the move to alternative payment methods, including Accountable Care Organizations and bundled payments, was well underway. "The momentum around more cost-effective care, or value-based care, isn't going away," Navigant's Rich Bajner tells HFMA. "We've already seen the commercial market follow the government effort by engaging providers in innovative relationships with providers."

Health plans and providers have responded to the public- and private-sector push for value-based reimbursement by experimenting with different revenue models based on the quality of outcomes. Bundled payment programs and total-cost-of-care arrangements help align incentives toward prevention and improve outcomes through timely, efficient, and coordinated care in the most appropriate settings.

Despite the uncertainty regarding the future of the Affordable Care Act (ACA), healthcare organizations are maintaining their movement toward value-based care and determining which payment programs best suit each of their unique situations, says Bajner.

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