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HHS Announces Shift in Medicare Reimbursements from Volume to Value – 1/27/15

On Monday, January 26th Health and Human Services Secretary Sylvia M. Burwell announced that the Medicare program, and the health care system at large,  will move toward paying providers based on the quality, rather than the quantity of care they give patients.

What does this mean for you and me?
Health care costs too much – for individuals, employers and governments that pay for health care. And the saddest fact of all is that our money often goes to tests and treatments we don’t need, administrative waste, and treating expensive conditions that should have been managed more cheaply by good prevention and primary care. The system is broken because we pay for the volume of services, instead of the value of the services provided. We need a bigger bang for our health care bucks.

Medicare is the most powerful payer of US health care. With this announcement, Medicare is giving health care providers some firm deadlines for changing how we pay for health care. The announcement comes right after Ohio’s Kasich administration received a $75 million, four year State Innovation Model (SIM)grant from HHS to move in the same direction – from volume to value. Having Medicare tightening the screws will push providers in Ohio’s SIM project to work all that harder.

However, where money is at stake, consumers need to be at the table. We need to help define “value” in health care. Value needs to reflect the personal needs, goals and preferences of each individual patient.

And, consumers need to make sure that, as providers reduce the amount of unneeded care provided, we have to make sure they don’t cut back on needed care to consumers.

Patients know what they need from the health care system. That’s why we need to make sure that patients and all consumers have a voice in these changes.

Click “read more” to learn more details about HHS’s announcement.