Panel Explores Accelerating Rate of Change in Value-Based Payment

More than 100 physician, hospital and health care leaders gathered at the 11th annual Thought Leadership Retreat at National Harbor, Maryland, in October.

While the transition fee-for-service to value-based payment and care-delivery models continues at a slower-than-expected pace, the number of operating value-based models is rather daunting for some in the physician community.

That was part of the discussion among more than 100 physician, hospital and health care leaders at the 11th annual Thought Leadership Retreat at National Harbor, Maryland, in October. The event was hosted by the Healthcare Financial Management Association in partnership with the American Association for Physician Leadership.

The federal Center for Medicare & Medicaid Innovation lists in its portfolio more than 60 value-based models, and that’s “just scary,” one attendee said.

Shantanu Agrawal, MD, president and CEO of the National Quality Forum, talked with a panel of AAPL-affiliated, seasoned leaders about the burden such an overload places on the physician community and the need to get alignment from different payers around models that are identified as successful.

Jim Landman, JD, PhD, director of HFMA’s Healthcare Finance Policy, Perspectives and Analysis division, says it’s important to get away from a system that asks physicians “to chase five different payment and delivery systems.”

Despite the large number of available models, the transition toward value-based models overall has progressed at a slower rate than what was anticipated when it began almost 10 years ago. Of the attendees rating the pace in their respective markets, more than 60 percent rated it as “slow” or “very slow,” while about 20 percent rated it as “progressive” or “very progressive.”

“I think one of the big questions that came out [of the retreat] is: What’s going to be the catalyst or driver for [accelerating] that change?” Landman says.

Some participants said the impetus for change ultimately will come from payers, although their ability to affect such change has been hindered substantially by the unpredictable future of the Affordable Care Act in Congress.

The private sector plays a role, too, Landman says, pointing to the Avia Innovator Network from Chicago. That group is applying digital technology to accelerate experiments and quickly scale them up across membership if something seems promising.

“There’s that sense that the big disruptor across the industry hasn’t appeared yet,” Landman says, “and no one knows exactly what it’s going to be. There’s an awful lot of people looking at what that answer might be.”

Amy Bassano, acting director of the Center for Medicare & Medicaid Innovation, told attendees there will be a transition from mandatory models to more voluntary models, and with a focus on more small-scale testing.

Adds Landman: “There’s going to be a focus, too, on models that empower consumers through greater transparency mechanisms and price quality. [The Innovation Center is] very interested in encouraging competition among providers and giving consumers a fair degree of choice in their selection of benefit models.”