The health care system must finish the transition from quantity-based care to quality-based care, industry leaders said at the U.S. News Healthcare of Tomorrow conference.
The health care system of the future must be value-based, industry experts agree. The question is: How quickly can the industry evolve?
“As we sit here today we’re still in both worlds, which is incredibly difficult to navigate,” said Marvin O’Quinn, president and chief operating officer of CommonSpirit Health, during a keynote discussion at the U.S. News Healthcare of Tomorrow conference in Washington, D.C., on Tuesday.
O’Quinn was joined on the panel by Dr. Vivian Lee, president of health platforms for Verily Life Sciences; Dan Liljenquist, senior vice president and chief strategy officer for Intermountain Healthcare; Dr. Vincent Nelson, vice president of medical affairs in the Office of Clinical Affairs for the Blue Cross Blue Shield Association; Dr. Rachel M. Werner, executive director of the Leonard David Institute of Health Economics at the University of Pennsylvania; and Seema Verma, administrator of the U.S. Centers for Medicare & Medicaid Services. The discussion was led by U.S. News Editorial Director Brian Kelly and Ben Harder, managing editor and chief of health analysis at U.S. News.
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While soundly in the middle of the transition from quantity-based to quality-based care, panelists said they are taking a close look at measuring the value of care and tying incentives to it.
It’s important to “not take a one size fits all approach,” said Werner. For providers that take care of a disproportionate share of vulnerable populations, “simply tying payment to value may not help improve quality of care for everybody,” Werner explained.
Both Lee and Verma noted the role that data and technology will play in assessing value. “The more data we have, the more effective we will be,” said Lee.
Verma said she sees CMS’s role as enabling competition by enabling shared data, but on the other side of value is making sure doctors are spending time with their patients and getting rid of all the unnecessary regulations that stand in the way of value. Establishing the right measures, while taking care not to overburden providers, is the goal.
Other panelists agreed that change needs to come from within.
“There’s no way the system can transform by external pressures,” said Liljenquist. “It’s got to come from an alignment of incentives and reorientation of what we decide health care should be.”
Blue Cross Blue Shield’s Nelson stressed the need to involve all health care stakeholders, including health insurance providers in deciding what value is and how it should be measured, but added that it must start with the patient.
O’Quinn added that partnerships and collaborations are one way to get everyone working together on value, in addition to focusing on the right key measures. Instead of thousands of ineffective measures that physicians get frustrated with very quickly, value can come from focusing on just a few things like managing hypertension and sepsis.
Panelists also examined what value means from a population health standpoint. “There’s no question that in every community, there are a number of systems and they are responsible for the health of that population,” said Lee.
Holding health systems accountable in competitive markets where more than one system competes for patients might be difficult, “though it may have the positive benefit of making systems work together to try and improve the population as a whole,” said Werner. She also emphasized the need to invest in the social determinants of health like housing, food and transportation to improve the health of communities.
Another common theme from the panelists: the march toward value needs to move faster.
“If we’re going to do value, let’s just do it. It’s almost impossible to live in both worlds,” said Lee. “The more we can go outside of traditional healthcare partners to help build the tools needed to make health the primary focus, the better off we will be.”
Source: US News