The House Energy and Commerce Health Subcommittee held a hearing on June 13 to discuss the transition to value-based care. The American Hospital Association (AHA) submitted a statement to the subcommittee expressing their support for this approach. In their statement, the AHA shared principles that should be considered when designing alternative payment models.
The AHA highlighted several key principles, including the need for an adequate on-ramp and glidepath to transition to risk, adequate risk adjustment, voluntary participation, and flexible design, balanced risk versus reward, guardrails to prevent participants from competing against themselves when achieving optimal cost savings and outcomes, and upfront investment incentives.
In addition to these principles, the AHA raised concerns about the Centers for Medicare & Medicaid Services’ newly proposed Transforming Episode Accountability Model, which is a mandatory bundled payment model. They suggested that CMS make participation voluntary and recommended a range of other changes to improve the model. Additionally, the AHA questioned the design elements of CMS’s proposed Increasing Organ Transplant Access model, which is a mandatory payment model for kidney transplants.
Overall, the AHA emphasized the importance of designing payment models that incentivize hospitals and healthcare providers to focus on improving patient outcomes while also controlling costs. By doing so, they believe that we can create a more sustainable and efficient healthcare system that benefits both patients and providers alike.
