Transform Care Delivery

Transforming how care is delivered is essential to ensuring that America’s health care system overall is high quality and affordable. There are too many inefficiencies in care delivery, such as fragmented coordination, duplicative or low-value services, and misaligned payment incentives that reward volume over value. To make care more affordable, hospitals, physicians and other providers must be empowered and incentivized to deliver the right care, at the right time and in the right setting.

Actions to improve affordability through value-based care transformation include:

• Enhance Accountable Care Organizations (ACOs). Strengthen ACO programs by fixing benchmark and risk-adjustment methodologies; modify shared savings levels to better support providers and patients; consider auto-enrolling high-need, high-cost populations into ACOs; and accelerate transitions to value-based care.
• Reform the Medical Liability System. Reform malpractice laws and implement tort reform, especially to protect providers who adhere to evidence-based medicine.
• Decrease Variation in Care. Standardize guidelines used in clinical decision support tools and purchasers’ prior authorization and coverage rules; and minimize utilization of low- or no-value services, procedures, drugs and devices.
• Remove Legal Barriers to Collaboration. Eliminate barriers that prevent doctors, hospitals and others from working together in integrated teams and clinical networks by modernizing outdated Stark and antikickback laws.
• Better Manage Advanced Illness. Increase access to palliative care services and adopt end-of-life conversations as a part of routine care.