Skip to main content

On January 26, 2015, the US Department of Health and Human Services (HHS) announced measurable goals and a timeline to move the Medicare program and the American health care system at large toward a "better, smarter, healthier" system in which payment to providers would be based on the quality, rather than the quantity, of care provided to patients.1  

A report published by the Health Care Payment Learning & Action Network (LAN) in October 20182 showed that, in 2017, 34% of US health care payments across all payer types—representing nearly 226.3 million people, or 77% of the covered US population—were tied to alternative payment models (APMs) based on value. Although that number constituted a "steady" increase from 23% 2 years earlier, it seemed clear that HHS's goal of 50% APMs by the end of 2018 would not be met.

Why is it that even though 90% of payers expect APM adoption to accelerate, according to the LAN report, progress to date has lagged? The report cited the following as the top 3 challenges to APM adoption: willingness to take on financial risk, ability to operationalize these models, and interest or readiness of providers.

Log in or create a free account to keep reading.


Join APTA to get unlimited access to content.

  1. US Department of Health and Human Services. "Better, Smarter, Healthier: In Historic Announcement, HHS Sets Clear Goals and Timeline for Shifting Medicare Reimbursements from Volume to Value." (Press release.) https://wayback.archive-it.org/3926/20170127185400/https://www.hhs.gov/about/news/2015/01/26/better-smarter-healthier-in-historic-announcement-hhs-sets-clear-goals-and-timeline-for-shifting-medicare-reimbursements-from-volume-to-value.html. Accessed July 23, 2019.
  2. Health Care Payment Learning & Action Network. Measuring Progress: Adoption of Alternative Payment Models in Commercial, Medicaid, Medicare Advantage, and Fee-for-Service Medicare Programs. https://hcp-lan.org/2018-apm-measurement/. Accessed July 23, 2019.
  3. American Physical Therapy Association. Health Value-Based Care Survey. http://www.apta.org/PaymentReform/StatusQuiz/. Accessed July 23, 2019.
  4. Warren M, Smith HL. Exploration of functional limitation codes for outpatient physical therapy in the Medicare population: a retrospective cohort study. Phys Ther. 2018;98(12):980-989.
  5. Center for Effectiveness Research in Orthopaedics. Evaluation of Legacy Patient-Reported Outcome Measures As Performance Measures in Rehabilitation. https://www.aptqi.com/wp-content/uploads/2019/07/Evaluation-of-Legacy-Patient-Reported-Outcome-Measures-as-Performance-Me....pdf. Accessed July 23, 2019.

You Might Also Like...

Article

2027 McMillan, Maley Lectures to Feature Leaders in Research and Education

Two accomplished leaders whose work has influenced physical therapist education, research, and patient care will take the stage at APTA Combined Sections

Article

Value-Based Care: APTA Resources to Help You Prepare

Explore tools, practical guidance, real-world examples, and member insights to help physical therapists navigate the shift to value-based care.

Article

What 2 DPT Students Learned at the Special Olympics USA Games

At the 2026 Special Olympics USA Games, held June 20-26 in Minneapolis, both students and experienced clinicians alike volunteered in roles that reinforced