CBO: mixed results for Medicare's value-based payment systems

Three of four value-based payment experiments reviewed by the Congressional Budget Office produced little or no savings for Medicare, according to a report released Wednesday. CBO suggested that substantial changes to payment and delivery systems will probably be necessary for value-based programs to significantly reduce spending and maintain or improve quality of care.

Of the three that failed to produce savings, two allowed providers to keep a portion of the estimated savings if they reduced total estimated Medicare spending and met certain quality-of-care criteria, while the other program offered financial bonuses if scores on quality-of-care measures were in the top tier of participating providers. CBO said the programs were affected by inaccuracies in determining a spending target based on historical cost growth. ...