Value Based Care, Here to Stay?

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Although there is still a lot of uncertainty around what direction the new administration will lead as it relates to healthcare, experts predict that value-based care is here to stay. While President Trump and other Republicans have promised to repeal and replace the Affordable Care Act, most agree that quality payment programs under MACRA will endure. This is primarily due to the fact that both the House and Senate had overwhelming support for MACRA.  Any delay or changes to MACRA must go through Congress, and due to the strong bipartisan support, this is unlikely.

In fact, just last week dozens of leading healthcare organizations submitted a letter to the Trump Administration in an effort to maintain federal support for value-based care and MACRA implementation. Organizations including the American Hospital Association, the American Medical Association, American Academy of Family Physicians, American Society of Anesthesiologists, Cleveland Clinic, Aetna, Blue Cross Blue Shield, and many others, called for the administration to accelerate, not delay, the transition from a fee-for-service system to value-based care.

The letter to the administration included ten policy principles these organizations consider essential elements of value-based care:

1. Empowering patients to make more informed healthcare decisions with support from their healthcare team.
2. Investments in ways to engage patients in the development of measures regarding provider performance, and ensuring these measures are transparent and reported by all public and private payers.
3. Expand clinician and provider access to accurate, and timely claims data to improve patient care management.
4. Acknowledge that the socioeconomic status of some patients may hinder their ability to receive quality care and adjust payments appropriately.
5. Design and adjust payment models that incentivize greater participation, and, support high-value services at a reduced cost based on patient choice and competitive markets.
6. Expand the use of waivers away from fee-for-service legal and regulatory requirements that hinder collaboration and shared accountability, while preserving consumer protections and safeguards against fraud.
7. Improve and expand payment models that promote collaborative financial arrangements and care coordination using incentives that align payers, healthcare providers, providers of long-term care services and clinicians.
8. Incentivize access to medical advancements and treatments with the potential to improve care quality and reduce overall system costs.
9. Encourage public and private investment in transparent, evidence-based testing and scaling of new alternative payment models in alignment with MACRA regulations, so that healthcare providers and payers can learn how payment models work and evolve in the clinical setting.
10. Ensure alignment between private and public sector programs, which is critical to a sustainable value-based payment marketplace.

Clearly, there has been a significant investment towards the transition to value-based care. Leading healthcare organizations are now urging the new administration to continue its transition and support, stating that without it the progress that has been made could otherwise be lost.