Health Affairs January 18, 2021
For almost the past four years, the Centers for Medicare & Medicaid Services (CMS) has sought to advance value-based care across all programs and initiatives, including through new payment models, reforms to the Accountable Care Organization (ACO) program, updates to reimbursement for primary care clinicians, and new strategies to accelerate the move to value in Medicaid. As part of this effort, the agency also removed barriers to value-based payments—such as by updating regulations pertaining to the Stark Law, requiring transparency on quality and price, promoting the interoperability of medical records, and overhauling a number of regulations to reduce provider burden.
Drug pricing is also a prime candidate for value-based reforms, especially given the advent of new high-priced but potentially curative...