What Is Value Based Care?

Value-based care programs reward health care providers with incentive payments for the quality of care they give to people with Medicare. These programs are part of a larger quality strategy to reform how health care is delivered and paid for. Value-based programs also support a three-part aim:

  • Better care for individuals
  • Better health for populations
  • Lower cost*

How Are Specialists Impacted by Value Based Care?

As value-based care accelerates across the healthcare landscape, one of the areas that will feel the greatest impact is in that of specialty practices. Specialists care for some of our nation’s sickest patients – those coping with chronic diseases, from cancer and arthritis to cardiovascular conditions and diabetes. Such illnesses are expensive, accounting for 86% of all U.S. healthcare costs, or nearly $3 trillion annually.  As a result, specialists are uniquely positioned at the intersection of quality, cost, and patient experience that MACRA was created to address.

Advances made in the fight against chronic illness, in partnership with specialty care, promise to pay disproportionate dividends in improving both the clinical and financial outcomes delivered by our healthcare system.

Studies  Indicate Lack of Readiness for Value Based Care

A number of studies are available that attest to the lack of readiness for value-based care among physician practices. A recent survey conducted by Integra Connect, engaging 80 oncologists at leading practices nationwide, found that 70% had not participated in alternative payment models (APMs) to date. Only 13% said that they understood the implications of MACRA for their practice. See the MACRA Preparedness Survey Results here.

*Source:  https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/Value-Based-Programs.html