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Stuart Guterman Describes the Challenge of CMS' Move to Value-Based Payments

As CMS moves to value-based payments, having good measures of value that payers and providers trust will be critical, explained Stuart Guterman, senior scholar in residence AcademyHealth.


As CMS moves to value-based payments, having good measures of value that payers and providers trust will be critical, explained Stuart Guterman, senior scholar in residence AcademyHealth.

Transcript (slightly modified for readability)

What is the biggest challenge of CMS' timeline of moving Medicare to value-based payments?

The big challenge is going to be to do it and to be able to come up with measures—if you're talking about value-based purchasing, then you need to have good measures of value. Although we've come a really long way in measuring the quality of care received by Medicare beneficiaries and other patients, we still have a long way to go. We're still in the adolescence of that process. So it's a challenge when you're talking about moving a lot of payment to a value basis if you don't have complete confidence in your measures of value. And that's going to have to be worked out.

I actually worked at CMS previously and we had to confront that kind of thing and we realized that until you start putting money that matters onto a set of measures, you're not going to be able to improve those measures the way you would if you could start realizing that payment is based on that.

I think there's a lot of work to be done: I think that's the challenge. And I think there has to be really good cooperation between the public and private payers and the providers to come up with measure that everybody trusts.

 
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