Meanwhile, the Independence at Home Demonstration resulted in average annual savings of $3,070 per participating beneficiary in the demonstration’s first year of operation. Under this demonstration , primary care practices share in Medicare savings that result from care coordination and in-home visits tailored to chronically ill patients’ needs. Finally, a recent Medicare demonstration to address avoidable hospitalizations among nursing home residents showed significant reductions in avoidable hospital admissions , achieved through enhanced medication management and nurse-led care coordination across primary and specialty care. In continuing implementation of delivery system reform, policy makers must work to develop payment models that avoid unneeded complexity. The new payment arrangements must be understandable to participating providers and patients, to achieve necessary engagement of both patients and providers in the care model. The Broader Landscape For Delivery System Innovation The delivery system innovation movement allows for the prospect of federal health programs building off of successful private-sector models, such as the Pacific Business Group on Health’s value-based payment programs for large employer-sponsored health plans. Such complementary efforts will help encourage the public and private sectors to coalesce around a unified long-term vision for delivery reform. Delivery system reform efforts have most often focused on breaking down payment silos in fee-for-service medicine and providing incentives for care coordination. Although these steps are critical to improving quality and promoting efficiencies, delivery system reform also presents an opportunity to foster person-centered care, including through the provision of non-medical social supports , for high-need, high-cost chronically ill individuals. Heightened focus on the high-need, chronically ill population will be increasingly important for delivery system reform, as these individuals incur medical expenses that are more than four times the national average . While Democrats and Republicans will continue to disagree on key aspects of health care policy, we firmly believe that the bipartisan work to enhance and improve the health care delivery system must continue unabated.
For the original version including any supplementary images or video, visit http://healthaffairs.org/blog/2017/05/18/preserving-the-bipartisan-commitment-to-health-care-delivery-system-reform/
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