Survey Shows Steady Rise in Value-Based Care Across Commercial Insurance, MA

  • Nov 22, 2024

    Alternative payment models (APMs), including value-based and accountable care, are growing across all lines of business, according to a survey from the Health Care Payment Learning & Action Network (HCP-LAN). Adoption of APMs increased from 41.3% in 2022 to 45.2% in 2023. Experts tell AIS Health, a division of MMIT, that while the results are encouraging, more work is needed to encourage adoption of value-based care arrangements, particularly in the commercial sector. 

    The annual survey, conducted by HCP-LAN in partnership with AHIP and the Blue Cross Blue Shield Association, gathered data from 73 health plans, four fee-for-service Medicaid states, and traditional Medicare. In 2023, 21.6% of commercial payments flowed through APMs with downside risk, in which providers are financially responsible for failing to meet quality and cost goals, compared to 16.5% in 2022. Medicare Advantage led the way with 43% of payments passing through downside-risk APMs in 2023 vs. 38.9% the previous year. Traditional Medicare had 33.7% of payments run through APMs in 2023 vs. 30.2% in 2022. And 21.1% of Medicaid payments flowed through APMs in 2023 vs. 18.7% in 2022. 

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    © 2024 MMIT
  • Jill Drachenberg

    Jill has been a reporter and editor since 2005, mainly focusing on business and health care. Before joining AIS Health, she was an editor for Relias Media (formerly AHC Media), focusing on topics such as case management, medical ethics, risk management, infection control, hospital management, and contraceptive technology. She has a B.A. in journalism from Georgia State University.

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