Albany partner Matt Amodeo was quoted in a recent BenefitsPro article titled, “How do you pay for value-based care?” The article discussed the concept of value-based care, and the shift toward paying providers on the basis of quality, rather than the current “fee-for-service” method. The article also discussed differences between the quality measures used in commercial value-based payment arrangements, and those used by Medicare in some of its programs, such as the Medicare Shared Shavings Program.
“Payers might develop quality metrics based on, for instance, performance levels determined nationally by top-tier providers, they’re setting the benchmark very high. A commercial payer could look at the highest-scoring, highest-quality cardiology group in the country and use that to set their benchmark for the cardiology providers participating in that commercial payer’s [accountable care organization] – and those metrics might look nothing like Medicare’s metric,” said Matt.
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