New Administration Sends Positive Smoke Signals About Value-Based Payments

Last week, the CMS announced a delay in publishing the final rules regarding the new mandatory cardiac and joint bundled payment programs. Significantly, the CMS did not dethe start dates of those programs, put them on hold, or cancel them all together. The new bundled payment programs will begin as scheduled, but the new administration will have a chance to make minor tweaks prior to the July 1 start date.

In spite of Secretary Price’s previous objections to mandatory CMMI programs, the green light from CMS foreshadows a continued commitment to value-based payments. A strong case can be made that the delivery system reforms instituted under the Affordable Care Act are a unique example of successful government intervention. There is compelling evidence to show that these programs have improved the quality of care for millions of people, saved hundreds of thousands of lives, and reduced spending by billions of dollars.

The pressure to reform will continue. Every provider needs to engage in value-based payment models today and begin the learning process. Currently, 30% of providers are engaged in value-based models. Provider engagement is expected to increase to 50% by 2018.  Now is the time to move forward or risk falling behind half the providers in America.

Several companies offer low-cost, supported participation in the Medicare Shared Savings Program for the third of physician groups who do not have 5,000 Medicare lives on their own. These companies include Collaborative Health Systems, Aledade, and Caravan Health.

Applications for 2018 are due to CMS on July 31st, with CMS letters of intent due by May 1st. Please reach out to us at if you would like to learn more.