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Evaluating value-based care

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Evaluating value-based care

Evaluating value-based care September 11, 2017

The Centers for Medicare & Medicaid Services (CMS) initiated the idea of value-based care and reimbursement as part of its Quality Strategy. The CMS value-based programs, designed to “reward health care providers with incentive payments for the quality of care they give to people with Medicare,” support the agency’s three-part aim of:

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

Any major program such as the value-based program, however, needs to be assessed on a regular basis to ensure that it continues to meet the needs of its stakeholders. In this case, the evaluation must focus on the benefit to providers as well as patients.

Participants in a Health Affairs forum held in April 2017 asked many questions around value-based care, with the goal of determining whether it needs to be revisited or revised. As reported in the Health Affairs Blog, the forum “built on the growing evidence that our current efforts aren’t working as designed, a topic of much debate across the quality/performance measurement communities.”

There was concern among the forum participants that “performance measurement could become an exercise in mandated compliance instead of actual performance improvement.” A key theme among the forum participants and many other independent physicians is that measurement and reporting can become an additional administrative burden.

Independent physicians are tasked with providing quality care to their patients along with the regular daily tasks of practice management. Even when taking advantage of technology tools that give them ready access to their patient records and that enable them to input and review patient data seamlessly, independent physicians continue to feel the added burden of reporting requirements under the value-based care program.

Health Affairs forum participants and others believe that it may be time to evaluate whether the value-based program, as it exists in its current form, is truly working to achieve its goals without further straining the resources of independent physicians.