Hill Briefing Focuses on Private Sector Innovation in the Alternative Payment Model Environment

The Healthcare Leadership Council (HLC) hosted a June 20 briefing on Capitol Hill that allowed its member companies to highlight how the private sector is helping guide the changing landscape of healthcare payment and delivery.  The passage of the Medicare Access and CHIP Reauthorization Act (MACRA) accelerated Medicare toward a pay-for-value orientation, and the healthcare industry has been focused on the most effective ways to shift to value-based care.

Dr. Robert Dowling, Vice President of Scientific Affairs and Policy at ION Solutions, an AmerisourceBergen subsidiary, spoke about how MACRA affects specialty providers.  He noted that, in the midst of moving to value based reimbursement, specialty practices will face significant pressures from many directions, such as ICD-10 and the Medicare Part B demonstration project, in a short amount of time.  He said there is a path forward to design payment models tailored to a specialty.

Jeff Farkas, Vice President of Health Policy and Payment for Medtronic, said that there is no pre-existing framework for medtech in the value- based care space.  He described the bundled care offerings that have optimized outcomes, and discussed steps the organization has taken to develop successful business models for performance around specific diseases.

Dr. Jordan Asher, Chief Clinical Officer and Chief Innovation Officer at MissionPoint Health Partners, an Ascension subsidiary, made the point that the United States excels in episodic care, however it needs to focus more on prevention and gaps in care.  He also stated that healthcare services are not just about access, but patient engagement and experience are key when looking for quality.