Medicare Advantage Leading the Way in Innovation
Health insurance plans are delivering greater value for Americans through the growing adoption of value-based care (VBC) to promote higher quality and more affordable care, the 2024 annual survey by the Health Care Payment Learning & Action Network (HCP-LAN) finds.
“The survey’s findings demonstrate a critical way in which health plans are leading the way to promote better care and greater affordability for patients,” said Danielle Lloyd, MPH, AHIP’s senior vice president of private market innovations and quality initiatives for Clinical Affairs. “Through the increased adoption of value-based care and innovative payment models, health plans are delivering on their promise to improve quality and care coordination while prioritizing prevention and managing costs.”
The LAN survey is conducted each year in partnership with AHIP and the Blue Cross Blue Shield Association (BCBSA) and is designed to understand how widely VBC models are being adopted as health insurance plans, clinicians, hospitals and health systems work together to move from paying for volume to prioritizing value for patients.
Key findings from the survey include:
- Continued growth in the adoption of VBC arrangements and shared risk arrangements. Across all lines of business, value-based arrangements grew by nearly 4 percentage points from 41.3% in 2022 to 45.2% in 2023. Shared risk arrangements also saw an increase, growing by 4 percentage points, from 24.5% in 2022 to 28.5% in 2023.
- Medicare Advantage continues to lead the way. Medicare Advantage (MA) continues to lead innovation in this space with 64.3% of payments in 2023 flowing through value-based arrangements, compared to 42% for fee-for-service (FFS) Medicare. This is a 7.1 percentage point year-over-year increase for MA plans from 57.2% in 2022, compared with a 0.6 percentage point increase for FFS over 2022.
- Commercial health plans continue making progress toward value-based adoption. Participation in commercial VBC arrangements grew from 34.6% in 2022 to 39.2% in 2023, a 5.1 percentage point increase. Adoption of downside risk arrangements in the commercial market also saw an increase of 5.1%.
To view the full 2024 HCP-LAN survey findings, click here.