Accountable alternative payment models held steady in 2024, according to a Feb. 2 survey by America’s Health Insurance Plans.
In 2024, 44.9% of healthcare payments stemmed from alternative payment models that ensure provider accountability for quality and cost of care. In 2023, 45.2% of payments fell into this bucket.
AHIP worked with CMS and the Blue Cross Blue Shield Association on the survey and analyzed data across health plan types, evaluating provider payments in 2024 or the most recent year of data available. CMS provided the original Medicare data, while participating states sent their own Medicaid data and responding health plans supplied the rest. The participants represent 87.5% of covered lives.
Here are five other notes from the survey, showing the state of value-based contracting in 2024:
1. Across all lines of business, 28.7% of healthcare payments came through a downside-risk alternative payment model contract.
2. Seventy percent of health plan respondents anticipate increased APM moves over the next two years. The key drivers: provider preparedness, plan engagement and the ability for plans to operationalize these approaches.
3. Twenty percent believe APM activity will remain steady.
4. Shared risk/procedure-based episode payments saw the highest growth potential, according to 55% of health plan respondents.
5. Alternative payment model spending in categories 3 and 4 (holding providers accountable for quality and cost) across all lines of business has increased since 2015.
