Travis Broome Weighs In on the Push to Mandatory Payment Models

The healthcare system has a long way to go to make voluntary payment models more attractive before it can consider making payment models mandatory, said Travis Broome, vice president of policy at Aledade.

At what point should voluntary payment reform models become mandatory? If ever?
Yeah, I, you know there’s this push towards mandatory, we... I think we should work really hard on the models, so that people want to volunteer. It’s a lot of hard work. Change is always hard. We’re asking for a lot of change. And when you’re talking about total cost care, the ACO [accountable care organization] model, you can put somebody in an ACO, but if they don’t do any change then of course they’re not going to succeed, then what was the point of mandating that they be in there if they’re not going to do the change.

So, I think we still have a long way to go on making the voluntary models more attractive, so more people volunteer…. So, I think on the total costs of care side, we have a lot of work to do on making the models the best they and can be and seeing how much volunteers we get, before we have to worry about mandatory.

On some of the episode models, the bundled models, you know, those have a much longer history with mandatory—[diagnosis-related groups], if you want to go back as far as you can. And I think there might be cases for a mandatory model in some of the episodes, but it will be just like I’ve said earlier, practices should be extraordinarily deliberate when they participate in the model and they shouldn’t just do it because it feels like the next thing. I would basically, CMS should take that same advice when it comes to mandatory models. Be very, very deliberate about why it’s mandatory and not just move something from voluntary to mandatory because it feels like the next thing.
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