Healthmonix Advisor

Value-Based Care: Stalled But Here To Stay

Posted by Christopher Jayne on August 3, 2018
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If you keep up to date about healthcare payment model trends, you may have noticed a newly re-ignited concern about the future of value-based care. A recent Quest Diagnostics survey highlighted perceptions that physicians lack the tools to succeed under the payment model, and that payers and providers are not well aligned in this endeavor. The survey further showed that over two-thirds of health plan executives and physicians believed the U.S. has a fee-for-service healthcare system versus a value-based care system. Overall, the study concluded that physicians and health plan executives perceive that progress toward value-based care has stalled.

But as thought leaders continue to weigh in, it’s important to keep in mind that on a broad scale value-based care models aren’t going anywhere, regardless of the pace at which we progress toward them. Rising healthcare costs, clinical inefficiency, and duplication of services remain major obstacles in the pursuit of quality healthcare, and any organization that hopes to survive in this increasingly competitive industry must understand that efficiency, and thus value-based care, matter more than ever for the bottom line.

Take for example another recent study, this one run by Change Healthcare, which shows that medical costs fell 5.6% on average under value-based care models, even as care quality and patient engagement improved. While it may feel safer to wait for greater industry-wide confidence before embracing value-based care, the reality is that those who do will be left behind.


Don’t be passive, be proactive.

Considering all of this, some organizations may aspire to make the shift, but may still find themselves unable to handle initial costs. Others may be waiting on higher incentives from CMS before they can justify jumping in. In both cases, these organizations can take proactive steps to make their voices heard, and may actually be able to encourage CMS to help ease the burden through legislative change.

Specifically, CMS is accepting feedback on the 2019 Proposed Rule for the Medicare Physician Fee Schedule until September 10, 2018. The Proposed Rule makes changes to the Quality Payment Program for both this year and in the future, which means it significantly impacts the majority of organizations participating in value-based care. So if the legislation as it currently stands is creating a significant obstacle for your organization, now is the time to act.

RELATED: A Summary of the 2019 MIPS Proposed Rule: Part 1

RELATED: How To Comment on the 2019 Proposed Rule

If you would like more information about the proposed rule or the Quality Payment Program in general, go to And in the meantime, subscribe to the Healthmonix Advisor for the latest tips and tricks in the world of value based care.


Topics: Industry insights, VBC