February 1, 2010

Medicare Payment Reform: Accelerating The Transformation of the U.S. Healthcare Delivery System and Need for New Strategic Provider Alliances

The Health Lawyer
Maria T. Currier

National Healthcare & Life Sciences Team Chair Maria Currier and Partner Morris Miller authored an article titled "Medicare Payment Reform: Accelerating the Transformation of the U.S. Healthcare Delivery System and Need for New Strategic Partner Alliances" in The Health Lawyer.

Unsustainable growth in Medicare spending and inefficiencies in the current Medicare fee-for-service payment system have prompted calls to transform the Medicare payment model from one based on rewarding volume to a system that pays for quality and favorable outcomes. Because Medicare is the largest payer in the U.S. healthcare system, it is critical for healthcare provider organizations to understand and prepare for the Medicare payment reforms that are likely to be implemented in the near future.

This article discusses some of the proposed Medicare payment reforms and demonstration projects that are receiving particular attention among policy makers and the Centers for Medicare and Medicaid Services (CMS). These reforms include the bundling of Medicare payments for acute care with payments for post-acute and physician services, the use of accountable-care organizations (ACOs), the development of medical home delivery models, and shared savings arrangements. This article also discusses some of the organization and legal implications of such reforms on healthcare providers.

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