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  • Private Health Care Purchasers Begin Shift to Value-based Payment Model

    Prominent national and regional business and labor health care purchasers are working together to change the way they and other private purchasers pay for health benefits to be based on the value, rather than the volume of services delivered by health care providers. The effort, known as Buying Value, takes advantage of major reforms in Medicare. By 2017, the Centers for Medicare and Medicaid Services will attach 9% of Medicare payments to some form of value purchasing.

    Buying Value is a collaboration of 18 diverse organizations that either represent or are themselves large health care purchasers—including Fortune 500 corporations, union health funds, and national and regional business coalitions. National consumer organizations also are also involved.

    The initiative is designed to encourage and assist private purchasers in making the switch from the traditional health care purchasing model of paying for care based on the number of individual tests or procedures performed, to a payment model based on the value or outcome of the overall care.

    The Buying Value project will develop a toolkit to help private purchasers rethink their health plans, as well as launch a public database showing different payment methods that purchasers can use to drive improvements in health care quality and safety. Organizers also will provide education and presentation materials and offer guidance on avoiding antitrust issues present in active purchasing. In addition to creating tools and resources that can be used by health care purchasers to guide their benefits plans, Buying Value organizers will conduct outreach at the local level to educate regional purchasers and consumer organizations.

    In order to facilitate and simplify alignment between private purchasers and Medicare, Buying Value has secured Medicare's commitment to support a common set of core measures for value purchasing in both areas. Development of the core measure set is under way at the independent Measures Application Partnership under a Medicare contract. The first phase of the project is due to be completed by October 1.

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