Virginia picked for health-care pilot program

Virginia has been picked as one of three states for a pilot program analyzing how well health-care payment reform is working.

The state pilot program, Virginia Scorecard 2.0, will be co-sponsored at the state level by the Virginia Center for Health Innovation (VCHI) and the Virginia Association of Health Plans.
Five health plans (Aetna, Anthem, Optima, UnitedHealthcare and Virginia Premier) were involved in Virginia’s selection by Catalyst for Payment Reform. Each of the health plans offered to report on claim and program analytics for commercial and Medicaid markets as part of the scorecard effort. 

“Recognizing the old adage that ‘we cannot fix what we cannot measure,’ VCHI aims to provide Virginia’s policy and political leaders with critical outcomes information that can be used to foster productive health-care reform discussions,” William L. Murray, chair of the VCHI board of directors, who is vice president for state and electric public policy at Dominion Energy, said in a statement.

“We are excited to have been selected to participate in the Scorecard 2.0 pilot, and believe the resulting analytics will fit well with our larger efforts to develop a Virginia Health Value Dashboard.” Murray said. “We believe payment reform is a necessary component of moving our health care system from one which rewards volume to one which rewards value, and as such we are highly interested in learning more about the extent to which it is being utilized in the commonwealth.”

New Jersey also has been selected for the pilot program. The third state has not been named.

Like Catalyst for Payment Reform’s (CPR) previous national and state-level Scorecards on Payment Reform, Scorecard “2.0,” will measure how much payment reform there is and of what type. Nationally, there is a movement away from the fee-for-service payment system toward models that reward health-care providers for patient health outcomes.

Scorecard 2.0 also will measure the impact that payment reform is having on the health-care system. In that effort, CPR has added 12 metrics to the Scorecard that, together with the original measurements, gauge the economic signals that insurers are sending to health-care providers, how the health-care system is changing and whether there is an impact on outcomes.

Particularly appealing to VCHI, Scorecard 2.0 will measure the proportion of health-care payments in the commercial and Medicaid sectors that meet CPR’s definition of “value-oriented.” 

Value-oriented payment means:

1) payment that reflects the performance (especially the quality and safety) of care that providers deliver; or

2) payment methods that are designed to spur efficiency and reduce unnecessary spending. 

If a payment method only addresses efficiency, it is not considered value-oriented. It must include a quality component.

The development and piloting of Scorecard 2.0 are funded by grants from the Robert Wood Johnson Foundation and the Laura and John Arnold Foundation. Results will be published in August 2018.