Jeff Micklos is the Executive Director of the Health Care Transformation Task Force, an industry consortium that brings together patients, payers, providers and purchasers to align private and public sector efforts to clear the way for a sweeping value transformation of the U.S. health care system. Under Jeff’s leadership, the Task Force provides a critical mass of business, operational and policy expertise from the private sector that, when combined with the efforts of the Centers for Medicare & Medicaid Services and other public and private sector stakeholders, can accelerate the pace of delivery system transformation.

Jeff is a great ally in this Race to Value, and the Task Force is doing its part to catalyze value-based payment adoption.  In January 2015, the task force was formed based on a commitment to the triple objective of better care, better health and lower costs. As a unique private sector coalition under Jeff’s executive leadership, the task force has an unrelenting vision to accelerate the pace of value-based care transformation.  Consequently, they have set the goal for payer and provider members in the Task Force to have 75% of their business in value-based payment arrangements by the end of 2025.

Listen to this episode to learn everything you need to know about the health policy landscape, strategic implications for payment and delivery transformation, and how redesigned payment models will help us seek sustainable improvements in health equity, patient outcomes, and consumer experience.

Episode Bookmarks:

01:40 Introduction to Jeff Micklos and the Health Care Transformation Task Force

03:30 The grim stats on the U.S. health system and the need to accelerate value-based care transformation

05:00 “Change is hard. And change is even more difficult when the status quo is so lucrative in fee-for-service medicine.”

05:30 30% of fee-for-service healthcare is related to low-value care (changing this is a major opportunity to sustain in the long-term!)

05:45 Changes to payment models and the market-driving force of Medicare reforms in healthcare transformation

06:00 HCTTF Transformation Goal: 75% of members operating under value-based payment arrangements by 2025 (progress made by reaching 61% in 2020)

06:55 CMS Innovation Center (CMMI) Strategy Refresh Target Goal:  All Medicare FFS beneficiaries in a accountable care relationship by 2030

07:15 “A financial spend metric (in and of itself) is not an indicator of success in value transformation.” (qualitative measures just as important!)

08:20 COVID-19 has only emphasized the need for significant payment and delivery transformation

09:30 The uncertain political climate and how that is shaping current delivery system reform efforts and private sector momentum for value-based transformation

10:00 Extension of the MACRA 5-percent Advanced APM incentive payment (currently scheduled to sunset in 2024)

11:00 The Build Back Better Act and its potential impact on improving health care and lowering costs

11:30 Increased coverage in the ACA marketplace exchanges as a success of the Biden Administration

11:50 The impact of the Russia-Ukraine situation on advancing health policy objectives in the near term

12:00 The upcoming midterm election and how the projected electorate change towards full GOP control may shift the political dynamics of the value movement

12:45 The CMMI Strategy Refresh as a guidepost for the future direction of the value movement

15:00 Reflecting back on the 1st 10 years of the CMS Innovation Center and lessons learned from theMedicare Shared Savings Program (MSSP)

15:50 “ACOs overall have played a key role in transforming the health care system by creating incentives for providers to deliver high quality, cost efficient care.”

16:10 Leveraging MSSP as a platform to scale provider adoption of other APMs

16:45 The failure to reach rural areas with APMs and the need for continued investmen...

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