Value-based care has been promoted by the Centers for Medicare & Medicaid Services (CMS) as a way to increase the quality of healthcare and reduce or eliminate the emphasis on the quantity of patient visits. In the value-based care model, independent providers are encouraged to focus on ways to improve patient outcomes rather than continuing to charge for repeated, often unnecessary, visits and procedures.
In January 2015, U.S. Secretary of Health and Human Services Sylvia M. Burwell said “Our goal is to have 85% of all Medicare fee-for-service payments tied to quality or value by 2016, and 90% by 2018. Perhaps even more important, our target is to have 30% of Medicare payments tied to quality or value through alternative payment models by the end of 2016, and 50% of payments by the end of 2018.”
However, in September 2017, Managed Care reported that a very small percentage of physicians were motivated by the value-based care incentives. One of the challenges may be that value-based care is “paperwork heavy.” The article cited a report that indicated that 73% of physicians still prefer the fee-for-service payment model.
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) created the Quality Payment Program that “changes the way that Medicare rewards clinicians for value over volume.” Managed Care points out that “the new payment program is saddled with an unwieldy, bewildering array of quality measures participating practices can choose to report on.”
CMS has recognized the burden that many of the new regulations and reporting requirements have placed on independent physicians and has “recently said it would pare down its massive list of measures but it remains too long for a typical physician practice to make sense of, physician advocates complain.”
Will the move to value-based care change for the positive in 2018? As Managed Care notes, that remains “an open question.”