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Report Highlights Challenges, Opportunities for Healthcare Delivery System Reform

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Michael Petruzzelli

, National Council for Behavioral Health

Report Highlights Challenges, Opportunities for Healthcare Delivery System Reform

August 28, 2014 | Uncategorized | Comments
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Payment reform is here to stay – but Congress and the Department of Health and Human Services must take steps to improve Accountable Care Organizations and other innovative delivery models. That was the message in a new report issued by the Bipartisan Policy Center (BPC) earlier this month. Transitioning from Volume to Value: Opportunities and Challenges for Health Care Delivery System Reform outlines key challenges and opportunities for providers and policymakers in transitioning from a volume-driven fee-for-service (FFS) system to one based on the quality and value of health care received. Of particular interest to behavioral health organizations, BPC’s recommendations include:

  • Structuring incentives to incorporate the full range of providers, not just physicians – For large scale reform to take place, the full range of practitioners and providers must be included in delivery structures and payment incentives. Currently, specialists and non-physician providers face significant barriers to participation that must be eliminated to realize the promise of accountable care.
  • Structuring new models to best engage and pay specialists – While the Center for Medicare and Medicare Innovation is expected to explore to new models for incorporating specialists, BPC recommends that policymakers do more to bridge the gap to appropriately integrate specialty care to payment models, such as mental health and addiction treatment providers.
  • Improved, streamlined quality measures – To facilitate reform efforts, policymakers must evaluate the complex nature and sheer number of quality measures and consolidate them to develop a limited and universal set of criteria for determining quality of care.
  • Determining the appropriate role of telemedicine – Appropriate use of telemedicine is key to the evolution of new models of care. Technology allows providers to expand access to care to medically underserved areas; however, there are a number of models for telemedicine coverage and implementation that may have differing effects on care quality and value.

The report also identified upcoming legislative and regulatory actions that could serve as vehicles for some of its recommended reforms. For example, in the coming months, Congress must once again act on a pending cut to Medicare physician pay, opening a window to enact these reforms. Some of these changes could also be made administratively, through changes to existing regulations on Medicare Accountable Care Organizations.

This report is the first in an upcoming series that will offer legislative and policy recommendations on the implementation and acceleration of delivery system reforms, taking into account the pragmatic realities of a shifting political environment that has dimmed hopes for comprehensive legislative solutions. Among other topics, upcoming reports will address innovations in the existing fee-for-service program, bundled payments, patient-centered medical homes, and improvements to Accountable Care Organizations.