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Building Out the Infrastructure for Value-Based Care

By Frank Irving

- The American Academy of Family Physicians (AAFP) is the latest organization to join the Health Care Transformation Task Force, a private-sector alliance promoting the adoption of value-based care across the U.S. healthcare system. With its Sept. 1 announcement, AAFP will collaborate with a consortium of providers, payers, patient organizations and policy leaders in a shared commitment to operate under value-based payment arrangements by 2020.

Infrastructure for value-based care

“We welcome the American Academy of Family Physicians as an important member of the task force’s work,” said Richard J. Gilfillan, MD, chair of the task force and CEO/ president of Trinity Health. “As primary care providers, family physicians are part of the foundation of a value-based, efficient and high-quality healthcare system. AAFP has been at the forefront in developing new care models intended to deliver better health, better care and lower costs. We are thrilled to have them now supporting our commitment to accelerating system transformation.”

The task force defines value-based payment arrangements as “those which successfully incentivize and hold providers accountable for the total cost, patient experience and quality of care for a population of patients, either across an entire population over the course of a year or during a defined episode that spans multiple sites of care.”

AAFP said in a statement that as the largest primary care physician specialty organization, it is “positioned to advance the task force’s goals to bring value-based care to patients of all ages and settings ... Moreover, family medicine has been a leader in advocating and adopting transformative, team-based practice designs that focus on ensuring seamless transitions among providers.”

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  • The early work of the task force, which formed in January 2015, is aimed at developing methods for identifying high-cost patients — those with advanced illness or high spending patterns — as potential enrollees in care management programs. The group recommends a hybrid of quantitative and qualitative approaches, combining available claims and electronic data with physician- or patient-reported information.

    The group also advocates the use of bundled payments for Medicare beneficiaries’ episodes of care, which it says would encourage coordination of care among providers. In a June letter to Andy Slavitt, acting administrator of the Centers for Medicare and Medicaid Services (CMS), the task force expressed its support for a voluntary, permanent expansion of a bundled payment program. The group called on CMS to distribute the software code used by agency contractors to bundle claims into episodes, which would assist in creating target prices. It also encouraged CMS to promote standard data definitions and file sets via HL7 connections to improve interoperability and access to data.

    Aside from providing policy and program-design recommendations, the task force is working on best-practice tools and benchmarks for its members to implement new care delivery and payment models. It will concentrate on improving the accountable care organization model, while developing a common bundled payment framework and continuing its efforts to improve care for high-cost patients.

    Commenting on the group’s formation earlier this year, David Lansky, president and CEO of Pacific Business Group on Health, said, “We need to align the way we pay for and deliver care with the outcomes we want: better quality and lower costs ... Our goal is transformation that achieves value and improved health outcomes.”

     

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