Four experts in value-based care share how a major disruption to the healthcare industry, like the COVID-19 pandemic, could be used to advance payer value-based care progress.
How do major disruptions affect the US healthcare system’s progress toward value-based care?
A recession, a widespread natural disaster, a public health emergency—significant national events like these have the power to build or break any healthcare system, but the American healthcare system, some have argued, is particularly vulnerable.
Healthcare spending contributed over 17 percent of the country’s gross domestic product in 2018, allowing shifts in healthcare spending to affect the economy at large. Recent events also painfully tested the belief that healthcare jobs are “recession proof,” as hospitals laid off 2.3 million workers in March and April 2020 due to the pandemic.
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The extremes and unknowns of a major disruption may impose chaos on the healthcare industry. However, disruptions like the coronavirus pandemic can also push the industry toward value-based care.
Across the industry, 43 percent of healthcare leaders agreed or strongly agreed with the statement that the coronavirus pandemic would propel the industry away from fee-for-service, according to a recent Insights report from Xtelligent Healthcare Media. Among those, nearly half of all payer respondents agreed or strongly agreed.
“Payers certainly have their pressures, but this is a real opportunity for them to think about how to take advantage of this silver lining and really move forward with the value-based new normal,” said Mark Fendrick, MD, Director of the Center for Value-Based Insurance Design at the University of Michigan.
Pursuing global payments, forming sustainable, long-term value-based care contracts, better integrating social factors, and re-evaluating healthcare spending are four key steps to maintaining value-based care progress during a major disruption, Fendrick and payer experts indicated.
ESTABLISH VALUE-BASED REIMBURSEMENT MODELS, GLOBAL PAYMENTS
Major healthcare disruptions can allow payers to rethink their current payment models and angle themselves more towards alternative payment models that will support providers through the disruption. Global payments can be a strong payment model in times of upheaval in the industry.
Source: Healthpayer Intelligence