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Health Reward Stat of the Day – Jan 19

money and steth pic

Catalyst for Payment Reform released its 2014 National Scorecard on Payment Reform:

  • 40% of commercial sector payments to doctors and hospitals now contain value-oriented payments. Defined as targeting improved quality and reduced waste.
  • In 2013, these payments only totaled 11%, a nearly 4X jump. This is a tipping point cleverly expressed as solving the Penguin Problem by industry analyst Vince Kuraitis; no one moves unless everyone moves.
  • Here are the categories that make up the 40%: Note that FFS = fee-for-service; P4P = pay for performance.
15.0% Full capitation 1.0% Shared risk
12.8% FFS-based + P4P 0.6% Non-FFS non-visit
6.7% Other 0.2% Non-FFS shared savings
2.0% FFS + shared savings 0.1% Bundled payment
1.6% Partial cap or by condition
  • Half of these payments are “at risk” and half are upside only. Specialists get 71% of payments and primary care 29%.

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