Mark Lutes Quoted in “Strategic Perspectives: Toward Value-Based Payments: Can CMS Deliver On Goals?”

Health Reform WK-EDGE

Mark E. Lutes, Chair of the firm’s Board of Directors and a Member of the firm’s Health Care and Life Sciences practice, in the Washington, DC, office, was quoted in Health Reform WK-EDGE, in “Strategic Perspectives: Toward Value-Based Payments: Can CMS Deliver On Goals?”

Following is an excerpt:

Given the current level of participation in risk-based models, will CMS be able to encourage new participants in the MSSP? Mark Lutes, chair of Epstein Becker Green’s Board of Directors and a Member of the firm’s Health Care and Life Sciences practice, noted that the “MSSP has succeeded in focusing provider attention on the opportunity to participate in managing the efficiency of care delivery to populations.” He maintained, however, that the program “faces challenges in getting a better balance of incentives to off-set the capital and operating costs of program participation,” especially if participants “are expected to forego the profits from conventional volume oriented medicine.” …

Despite problems with the MSSP, Lutes believes that CMS’ goal to have 30 percent of providers in the Medicare program engaged in alternative payment models by 2016, and 50 percent by 2018, is possible. He stipulated, however, that “some of the categorization may be ‘soft’ and the announcement implicitly recognizes that changing provider incentives will require that their overall, commercial and government pay ‘book’ reach a ‘tipping point’ in value based incentives.” Crosswhite disagreed as to the feasibility of CMS’ plan, referring to the goal as “ambitious.”