The Trump administration unveiled a new program Monday to pay primary healthcare providers based on patient health and outcomes rather than on specific services and procedures.
Health and Human Services Secretary Alex Azar announced that his agency would experiment with two new payment models based on results, using existing administrative authorities. The tests are projected to enroll a quarter or more of traditional Medicare beneficiaries and a quarter of providers that pay for keeping patients healthy.
With these payment models, the Centers for Medicare & Medicaid Services will “test out paying for health and outcomes rather than procedures on a much larger scale than ever before,” Azar said.
The first primary care model will focus on smaller primary care practices, which will be paid a flat fee per patient. If the patient stays healthy, the practice will receive a bonus. But if the patient does not, the practice must pay a penalty.
The second model applies to larger practices and allows them to voluntarily assume different risk level payments. Like the first model, the practices are paid based on patient outcomes. But practices will have more control over how the funds are spent, “allowing them to come up with innovative ways to care for patients, and receive significant savings if they keep patients healthier than expected,” Azar said.
Local entities could also be awarded funds to focus on a specific area, promoting positive patient outcomes on a local, community level.
Azar said the new system “will radically elevate primary care in American medicine.”
