A major shift in the healthcare industry occurred yesterday when HHS Secretary Sylvia Burwell announced measureable goals and a timeline to transition Medicare, and the overall healthcare system, to paying providers based on performance. U.S. healthcare has traditionally been reimbursed per visit, procedure, test, surgery, etc. The Affordable Care Act of 2010 created new payment models that reward providers based on quality measures and reducing costs. Pay for performance models include Accountable Care Organizations, primary care medical homes and bundling payments for episodes of care.
Today, Medicare payments account for 20 percent of payments made to providers through alternative models. In an effort to step up the transition, Burwell announced that alternative payment models will account for 30 percent of Medicare payments by 2016 and 50 percent by 2018. During the transition to pay for performance models, technology will play a critical role in their successful adoption. Healthcare providers will need interoperable electronic health records to share information among healthcare professionals, telemedicine and remote patient monitoring.
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