Entering the Next Phase of Value-Based Care, Payment Reform

The healthcare industry has in earnest attempted to transform not only clinical outcomes, but also the financial aspect of care for about a decade now. Yet progress with the adoption of alternative payment models (APMs) has been slow, explained McClellan, the former CMS administrator and current Robert J. Margolis MD Professor of Business, Medicine and Policy, Fuqua School of Business.

One in three healthcare payments flows through an APM, the Health Care Payment Learning & Action Network (LAN) – which McClellan also serves as co-chair for their Guiding Committee – recently found using the latest data from 62 health plans, seven fee-for-service Medicaid states, and traditional Medicare.

But fee-for-service still dominates even a decade later.