The National Scorecard and Compendium on Payment Reform

"The results of the first annual Scorecard are in and 10.9% of all commercial in-network payments are value-oriented either tied to performance or designed to cut waste."

Catalyst for Payment Reform (CPR), an independent, non-profit employer coalition pushing for better value in health care, today released its first annual National Scorecard on Payment Reform. The Scorecard shows that only about 11 percent of the health care dollars we pay to doctors and hospitals today are value-oriented -- tied to how well they deliver care or create incentives for both improving quality and reducing waste. Almost 90 percent of payments reported remain in traditional fee-for-service, paying providers for every test and procedure they perform regardless of necessity or outcome, or in bundled, capitated, or partially-capitated payments without quality incentives. Within the 11 percent of payment that is value-oriented, the Scorecard finds that 43 percent of those payments give providers financial incentives by offering a potential bonus or added payment to support higher quality care, such as fee-for-service with shared savings. The other 57 percent of payments put providers at financial risk for their performance if they do not meet certain quality and cost goals, such as bundled payment.

The National Scorecard on Payment Reform uses data submitted on a voluntary, self-reported basis to eValue8, the National Business Coalition on Health’s annual Request for Information to health plans. The plans responding to the Scorecard questions represent almost half of the commercially-insured lives in the U.S. While Scorecard findings are not wholly representative of health plans across the U.S., they offer a preliminary baseline against which to measure progress toward value-oriented payment in the commercial sector. CPR has made all findings, including a breakdown of payment methods, a glossary of terms, and the Scorecard methodology available online.