Value-based models picked up steam in 2023: 5 numbers to know

The percentage of healthcare risk dollars in two-sided risk arrangements grew across all types of health plans in 2023, according to the Healthcare Payment Learning and Action Network's annual report. 

The report, published Nov. 14, includes data from 73 health plans, accounting for around 92.8% of those insured in the commercial, Medicare Advantage, Medicaid and traditional Medicare markets. 

Here are five key numbers to know: 

  1. In 2023, 38.4% of healthcare dollars were spent in fee-for-service arrangements with no link to quality or value, down from 40.6% in 2022. According to the survey, 28.5% of healthcare dollars were spent in arrangements with downside risk, up from  24.5% in 2022.

  2. Medicare Advantage and Medicare had the highest share of payments with downside risk in 2023. In Medicare Advantage, 43% of payments were in models with downside risk in 2023, up from 39.9% in 2022.

  3. In traditional Medicare, 33.7% of payments were made in two-sided risk arrangements, up from 30.2% in 2022.

  4. The commercial market saw the largest growth in two-sided risk payments from 2022 to 2023. In the commercial market, 21.6% of payments were in two-sided risk models in 2023, up from 16.5% in 2022.

  5. In Medicaid, 21.1% of payments were in two-sided risk models in 2023, up from 18.7% in 2022.

Read more here. 

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