PEPC joined 16 other national healthcare organizations in urging the Department of Health and Human Services (HHS) Secretary Xavier Becerra to press forward on innovative alternative payment models (APMs) as part of its strategy to achieve health equity.
In a letter sent to Secretary Becerra, the groups underscored how APMs routinely leverage multi-disciplinary approaches to care, assess social risk, partner with community organizations to increase access to nonmedical services, and leverage data to improve disparities in patient outcomes. To support and accelerate these efforts, the organizations recommend that HHS:
- Build in flexibilities and payment for APM participants to strengthen their focus on addressing health inequities, such as incorporating social determinants of health into risk adjustment
- Ensure thresholds for clinicians to receive bonuses for participating in risk-bearing APMs can reasonably be met to encourage clinicians to remain in or join these programs
- Set a clear plan for moving beyond testing to scaling the best approaches so that healthcare providers are eager to invest in these innovative models
- Address overlap in value-based care programs to remove conflicting incentives, align goals of improving quality and outcomes and ensure providers are not disadvantaged for participating in multiple models
- Develop a stable suite of models that help clinicians advance through the value-based continuum over time
- Utilize the Medicare Share Savings Program (MSSP)—which generated $1.9 billion in net savings to Medicare in 2020 alone and had an average quality score of almost 99 percent—as an innovation platform
- Provide greater technical support to APM participants to reduce burden associated with model participation