Travis Broome Discusses Participating in Multiple Payment Reform Models

Practices should make deliberate choices when choosing to participate in multiple payment reform models and should just participate in something because it is the newest model, said Travis Broome, vice president of policy at Aledade.

Transcript

The new HHS primary care payment models are just the latest in a long line of payment models from the government and private sector. How well are practices balancing it if they’re participating in multiple models?

Yeah, so you really have to think about it from your practice perspective: what are the models that best align with my goals as a practice? So, you know, model we didn’t' talk about, Million Hearts has been out for a while. Like, you know do I have to be in a Million Hearts if I care deeply about cardiovascular care and that’s an emphasis of my practice? And so I think practices have to be very, very deliberate about which ones they add on to their repertoire, because, I mean, you know we try and make it as simple—CMS tries to make it a simple administrative burden, you know Aledade tries to make it even simpler still with our partner practices, but at the end of the day you’re going to know right now that you’re in the model and the more models you add, the more burden you’re adding and the more you’re taking on.

So, it really comes down to as a practice, looking at is like, “What is the reason I’m going to take that on? Does it further my goals as a practice for better care for my patients and better health for my patients? Or am I just taking it on because I feel like it’s the thing I should do?” Right, so as long as you’re deliberate about it you know we have practices that participate in multiple models and I think practices should be willing you know to consider multiple models, but at the same time just be very deliberate. Like, “I want this out of this model.” Don’t just sign up just because it’s the new model.

Are they able to understand clearly which models are impacting which outcomes or are the waters getting a little muddied?

Yeah, I think from a practice’s perspective, they probably don’t even need to think of it that way, of like you know I’ve made the commitment to like, we’re talking about break away from the, if I do Primary Care First, break away from the 15-minute block schedule and I think that’ll lead to better care and lower costs. So, that in, you know, Primary Care First enables that, total cost of care shows up in the Medicare Shared Savings Program, if I do both… And so I think the outcomes should come from the combination of it and I don’t think we need to, at least again at the practice level, the provider level, CMS has got to do its evaluation and the research, we’ll let the researchers figure out like, which model which, right? But as long as the practice knows what they’re getting out of each model they can look at the single outcome of better quality and lower cost.