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AHIP: New Alternative Payment Model Survey Shows Strong Commitment to More Affordable, Accessible, Equitable Care

Press Release

Published Nov 9, 2022 • by AHIP

Washington, D.C. – November 9, 2022 – Matt Eyles, President and CEO of AHIP, issued this statement as the Health Care Payment Learning & Action Network (LAN) released the results of its calendar year 2021 Alternative Payment Model (APM) survey. The LAN survey is designed to understand how widely value-based care models are being adopted as health insurance providers and hospitals and health care systems collaborate to move from a health care system based on volume of services, to one based on value of care provided to the patient. The LAN APM survey is fielded with the support of AHIP and the Blue Cross Blue Shield Association (BCBSA).

“Every American deserves affordable coverage and high-quality, equitable care. That’s what health insurance providers are committed to delivering: More choices, better quality, and lower costs. Value-based models for delivering care are essential for putting the patient first, creating aligned incentives that reward everyone for helping patients get healthier faster, and stay healthier longer. AHIP is honored to continue our long-standing partnership with the LAN on the Advanced Payment Model survey as part of our commitment to more affordable, accessible care and better health for everyone.

“There is no question that many strains were placed on America’s health care system in 2021, as everyone worked together to overcome the COVID-19 pandemic. Yet, value-based payment models were a constant, with increasing participation in arrangements that enable providers to share both the risk and rewards. These findings support what we have heard from our members, particularly over the last 3 years: Value-based payment models are not only good for patients, they are good for clinicians, hospitals and health care systems by supporting these partners through greater financial predictability, stability and flexibility even in the most dire health crises.

“We all have a role to play in improving health care affordability, quality, and equity for Americans. Health insurance providers are committed to guiding greater health through innovative payment models and collaborative relationships, so that together, we can ensure that everyone has the opportunity to thrive.”

Key Findings from the survey of 2021 data include:

  • The survey reflects a strong majority (77%) of people who are covered in the United States. This makes the survey a good barometer of how Americans are being cared for through value-based care arrangements.
  • On average, 40% of U.S. health care payments flowed through advanced payment models across all payer types (Categories 3-4).
  • Participation in risk-based models increased, with 1 in 5 (20%) of U.S. health care payments flowing through risk-based advanced payment models (Categories 3B-4).
  • Medicare Advantage plans continue to lead the way, with 57% of payments flowing through any sort of advanced payment model, and 35% of payments flowing through risk-based advanced payment models. Such strong adoption is a clear indication of Medicare Advantage’s commitment to improved affordability and value.
  • Many plans are leveraging value-based care arrangements to improve health equity. For example, 46% are incentivizing providers to collect standardized race, ethnicity, and language data. Further, 37% are incentivizing screening for socioeconomic barriers through these arrangements.
  • A strong majority - 83% - of payers believe that engagement in advanced payment models will increase in the future.

Read the survey results.

About AHIP

AHIP is the national association whose members provide health care coverage, services, and solutions to hundreds of millions of Americans every day. We are committed to market-based solutions and public-private partnerships that make health care better and coverage more affordable and accessible for everyone. Visit www.ahip.org to learn how working together, we are Guiding Greater Health.