20 Aug Enhancing Provider Experiences in Medicare Advantage Value-Based Models
HCTTF developed recommendations for the Center for Medicare & Medicaid Innovation (CMMI) to enhance provider experiences in Medicare Advantage (MA) value-based arrangements. This issue brief assesses MA investment in value-based arrangements, discusses provider experience in these models, and identifies opportunities for CMMI to promote best practices in this market.
Because CMMI has operated a limited number of MA models, we recommend beginning with voluntary models that compare new and existing methodologies by:
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- Conducting “shadow tests” of new payment methodologies, including changes to risk adjustment, benchmarking, and quality measurement. CMMI should concurrently test both existing and new methodologies (e.g., shadow test) for 3 years.
- Avoid mandating untested methodologies. If CMMI applies new risk adjustments to mandatory models, this could inadvertently prompt payers to withdraw from certain markets and providers to exit partnerships.
- Seek opportunities to incentivize established best practices in future models and potentially build modular contract templates.
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As MA continues to expand, it is essential to continue promoting MA value-based arrangements, while also improving provider experiences and patient outcomes under these programs.