Statement Highlights:
E mbargoed until 4:00 a.m. CT/5:00 a.m. ET, Monday, July 10, 2023
DALLAS, July 10, 2023 — The American Heart Association, a global force for longer, healthier lives for all, is advocating for a shift away from the current health care payment system in the U.S., which is primarily based on fee-for-service, to a value-based payment (VBP) system. A VBP system is person-centered, equitable, coordinated and seeks to improve outcomes and experiences for patients and clinicians, while controlling costs.
Health care payers, including the U.S. Centers for Medicare and Medicaid Services (CMS), major employers and health insurance companies, are increasingly adopting new payment models based on quality of care and cost of care. In the new American Heart Association policy statement, “Value-Based Payment for Clinicians Treating Cardiovascular Disease,” the Association summarizes the current landscape of VBP for cardiovascular disease clinicians and outlines recommendations for increasing its adoption. The new policy statement published today in the Association’s flagship, peer-reviewed scientific journal, Circulation .
In the traditional fee-for-service system, clinicians are paid based on the number of services provided, which does not include consideration for quality of care, patient outcomes or resource utilization. In a VBP system, improved quality and outcomes are the focus.
“Value-based care delivery and payment models hold the promise of producing better patient outcomes and lowering costs,” said Karen E. Joynt Maddox, M.D., M.P.H., FAHA, vice chair of the policy statement, a member of the American Heart Association’s Advocacy Coordinating Committee and an assistant professor of medicine at Washington University in St. Louis in St. Louis, Missouri. “Value-based programs represent an important but under-recognized opportunity to improve the clinician’s experience and the efficiency, quality and value of patient care.”
The new policy statement emphasizes the critical need to set a framework for VBP programs as they expand, prioritize equity and leverage VBP models to improve health outcomes among populations with the highest risk for chronic disease.
The policy statement’s recommendations for value-based care delivery and payment models include:
The statement also outlines key themes for the future of successful VBP programs and payment reform for cardiovascular care:
The recommendations are consistent with the CMS Innovation Center Strategy Refresh that was published in October 2021 to promote “a health system that achieves equitable outcomes through high quality, affordable, person-centered care.” In collaboration with the Duke-Margolis Center for Health Policy, the Association expressed support for CMS’s recommendations in a 2022 white paper addressing improving heart health through value-based payment.
American Heart Association policy statements position the Association on issues that will impact cardiovascular health and mortality, guide our advocacy work at all levels of government, allow us to support the important work of others, and inform policymakers, practitioners, health care professionals, researchers, the media and the public.
Co-authors and members of the writing group are Chair Paul Heidenreich, M.D., M.S., FAHA; Alexander T. Sandhu, M.D., M.S., Vice-Chair; William Borden, M.D., FAHA; Steven A. Farmer, M.D., Ph.D.; P. Michael Ho, M.D., Ph.D., FAHA; Gmerice Hammond, M.D., M.P.H.; Rishi K. Wadhera, M.D., M.P.P., M.Phil.; Jason H. Wasfy, M.D., M.Phil.; Cathie Biga, M.S.N.; Edwin Takahashi, M.D.; Khamal D. Misra, M.S.N.; and Janay Johnson, M.P.H. Authors’ disclosures are listed in the manuscript.
The Association receives funding primarily from individuals. Foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers, and the Association’s overall financial information are available here .
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About the American Heart Association
The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations and powered by millions of volunteers, we fund innovative research, advocate for the public’s health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org , Facebook , Twitter or by calling 1-800-AHA-USA1.
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Circulation
Value-Based Payment for Clinicians Treating Cardiovascular Disease: A Policy Statement From the American Heart Association