Health System Transformation
The ·¬ÇÑÊÓƵ, through research, advocacy and patient education, supports transforming health care in the United States to a more effective system that recognizes and pays for better care and outcomes. We support a health care system that is person-centered, focused on improving individual and population level experience and health outcomes, promotes health equity and rewards our health care workforce for the quality of care they provide rather than volume of services they can bill regardless of outcomes.
Despite not guaranteeing universal coverage, the United States spends far more per capita on health care than any other country. Compared to other developed countries, we perform poorly on overall indicators of population health with profound disparities in the health of our communities. Our current fee-for-service system rewards providers who do more rather than provide higher quality care. It emphasizes treating sickness rather than overall health and prevention. As it is currently set up, fee-for-service is focused on the provider, not on the patient or consumer, resulting in fragmented care. Value-based care is an alternative, which, if done correctly, holds significant promise for improvement across five main areas:
- Enhanced care experience
- Healthier patients
- Smarter spending
- Improved health equity / optimization
- Enhanced provider accountability, support and satisfaction
Better for patients; Better for health care team members—Research conducted by the ·¬ÇÑÊÓƵ found that care provided through ACO models is better for patients and better for health care team members. The AHA conducted 27 in-depth, semi-structured interviews across the country with medically complex patients and/or their family caregivers and members of the health care team who receive or provide care through an ACO model.
The findings support efforts by AHA and other patient and consumer advocacy organizations, policy makers and others to advocate for changes to the health care delivery and payment system that improve the experience of care, outcomes and efficiency for all stakeholders.
Issue Briefs
In spring 2018, the ·¬ÇÑÊÓƵ, in collaboration with the Duke-Margolis Center for Health Policy, launched Value in Healthcare Initiative – Transforming Cardiovascular Care to begin an important conversation about the problems facing patients in accessing and deriving quality and value from the healthcare system.
Forty pharmaceutical, pharmacy, payer, pharmacy benefit manager, healthcare provider, health system, government, technology, and patient leaders joined us in making a bold commitment in support of a shared vision for the healthcare system of the future and accelerating solutions to improve patient access, outcomes, and value.
Our Work
The Patient Voice
Meet our Leadership & Participants
Media
In October 2021, the Centers for Medicare and Medicaid Services (CMS) Innovation Center released the Innovation Center Strategy Refresh, a new vision intended to guide the next phase of health system transformation. In this vision, the CMS Innovation Center outlined an aggressive new strategy seeking to achieve equitable outcomes through high-quality, affordable, person-centered care, with 5 strategic objectives (show figure attached):
- Driving accountable care: Increase the number of beneficiaries in a care relationship with accountability for quality and total cost of care.
- Advancing health equity: Embed health equity in every aspect of CMS Innovation Center models and increase focus on underserved populations.
- Supporting care innovations: Leverage a range of supports that enable integrated, person-centered care, such as actionable, practice-specific data, technology, dissemination of best practices, peer-to-peer learning collaboratives and payment flexibilities.
- Improving access by addressing affordability: Pursue strategies to address health care prices and affordability and reduce unnecessary or duplicative care.
- Partnering to achieve system transformation: Align priorities and policies across CMS and aggressively engage payers, purchasers, states and beneficiaries to improve quality, achieve equitable outcomes and reduce health care costs.
As part of the strategy refresh, the CMS Innovation Center sought input from stakeholders. To provide input on the strategy refresh, the ·¬ÇÑÊÓƵ together with the Duke Margolis Health Policy Center convened a group of experts from different backgrounds and perspectives to identify best practices for addressing cardiovascular health and provide suggestions for incorporating cardiovascular disease prevention and management best practices into the design and implementation of value-based payment models. The expert panel met on 3 occasions between November 2021 and January 2022 and developed recommendations aligned with each of the 5 CMS Innovation Center strategic objectives.
The ·¬ÇÑÊÓƵ supports a health care system that is person-centered, focuses on improving individual and population level experience and health outcomes, promotes health equity, and rewards our health care workforce for how well they do versus the number of billable services regardless of outcomes. Below are AHA publications addressing the need for health care delivery and payment reform and to move away from traditional fee for service. Value-based care (or person-first care) offers the opportunity to improve our health care system. As value-based care grows and evolves it is essential that organizations like AHA are engaged to ensure the changes are truly person-centered and ensure that everyone has access to high-value, whole person-centered care that is affordable.
- , AHA is a member of the HCPLAN
- Health Care Transformation Task Force: AHA is a member of HCTTF
- HCTTF Consumer Resources
- HCTTF Consumer Resources
- : AHA participates on the A4H
- National Association of ACOs (NAACOS)
- for patient representatives on the ACO Boards