The HQC formed as a consensus-driven, ad-hoc group in 2009 during the deliberations of the Affordable Care Act to urge Congress to focus on value-based care policy. Comprised of health systems, cooperatives, physician groups, and medical and hospital associations, the HQC was successful in collaborating with policy champions to establish statutes to reimburse hospitals and physicians based on value. Although still built on the fee-for-service chassis, policies such as the physician value-based payment modifier, and hospital value-based purchasing laid the groundwork for integrating quality and cost measures into how physicians and hospitals are reimbursed for services. The HQC also worked with key members to secure studies commissioned by the Institute of Medicine on geographic disparities and payment adjustment policies based on the location of where services are provided.
The coalition formalized in 2011 and steadfastly focused on the implementation of the programs enacted in the Affordable Care Act. Through promoting value based on quality and cost focused on measures of outcomes, the HQC stood at the forefront of supporting policy to aggressively move programs forward to achieve the goal of better patient care at lower cost.
In 2015, Congress enacted the Medicare Access and CHIP Reauthorization Act (MACRA), aimed at repealing the antiquated sustainable growth rate formula. However, much of the policy framework oriented on value-based care, and not only repealing a spending formula. With this, existing programs in Medicare Part B, including the Physician Value Modifier, were consolidated into a new initiative known as the Quality Payment Program. The coalition continues engage on implementation of the QPP to move value-based care forward.
Moving forward, the HQC continues to be interested in legislatively improving the existing hospital value and pay-for-performance programs. In addition, the coalition intends to partner on policy issues to remove regulatory and administrative barriers to care that neither improve health or lower cost. Finally, a continuous strategy is engaging with regulatory officials on legacy performance programs and emerging payment models aimed at moving away from fee-for-service. Learn more about our current policy work here.