Investing in Value-Based and Innovative Healthcare

HLC Position:

HLC has long advocated on the importance of value-based care. HLC believes opinion leaders and decisionmakers must be made more aware of the benefits to be gained from a transition away from conventional fee-for-service payment systems to value-based care structures that align incentives, resulting in greater patient-centeredness while achieving savings and cost-efficiencies without diminishing care access or quality. HLC continues this type of educational outreach. A Congressional Budget Office (CBO) report on the financial impact of the Center for Medicare and Medicaid Innovation (CMMI) in its first decade found that the agency’s activities added to the federal deficit instead of reducing it. HLC will utilize this finding to continue making the case that CMMI should focus its resources on pilot programs that advance value-based care throughout the health system and that it should reduce the administrative burdens and duplications that have dissuaded healthcare entities from participating in demonstration projects.

HLC 2023 Activity:

• HLC continues to support CMMI’s work toward a coordinated and efficient health system, including:
  • Publishing a blog post, “The CBO Report and Lessons for CMMI’s Future,” outlining important areas to focus CMMI’s work in its second decade to create impact and improve cost-efficiency. These include focusing the lion’s share of its efforts on developing sustainable models that have bipartisan support and will achieve meaningful savings through patient-centered coordinated care and ensuring that providers’ incentives to participate in the models are not outweighed by burdens of operating under the models.
  • Meeting over the August recess with key committee staff having jurisdiction over CMMI to discuss ways to educate “rank and file” members of Congress about CMMI and how to improve CMMI’s effectiveness.
  • As an invited member of the Health Care Payment Learning and Action Network’s (LAN) Accountable Care Action Collaborative (ACAC), provided strategic input. Attended the LAN 2023 Summit on October 30 and participated with diverse stakeholders in collaborative discussion on the shared mission to lower care costs, improve patient experiences and outcomes, reduce the barriers to alternative payment model (APM) participation, and promote shared accountability.
  • Hosting regular meetings for HLC members and outside stakeholders to discuss CMMI policy and legislative strategy to ensure the entity is best equipped to bring better value to Medicare and Medicaid beneficiaries via APMs.
  • Hosting a webinar, “Multisectoral Approach to Patient-Centered Care,” highlighting how several HLC member companies and organizations have implemented changes in patient-centered care and moved away from fee-for-service in a way that pays for improved health outcomes.
• In response to a House Budget Committee request for information (RFI), HLC shared solutions to modernize the nation’s health system to both improve patient outcomes and reduce spending. Solutions included continuing the transition to value-based care, protecting and improving Medicare Advantage, and making CMMI more effective, among others.
• HLC wrote the Senate Committee on Health, Education, Labor and Pensions (HELP) in advance of its hearing, “Community Health Centers: Saving Lives, Saving Money.” In its statement, HLC urged the committee to explore further value-based care as a better long-term way to align the healthcare workforce and address shortages.
• HLC joined a group letter to the sponsors, including Representatives Darin LaHood (R-IL), Suzan DelBene (D-WA), Brad Wenstrup (R-OH), Earl Blumenauer (D-OR), Larry Bucshon (R-IN), and Kim Schrier (D-WA), in support of R. 5013, the “Value in Health Care Act,” to strengthen the Medicare program and ensure high quality, lower cost care for beneficiaries.