Value-Based Care: A 2021 Priority

Key Learnings

  • The move to fee-for-value was accelerated by COVID-19
  • A new presidential administration will prioritize value-based care in 2021
  • The quadruple aim and value-based care will intersect

It has been in the healthcare lexicon for years now – value-based care – and while there have been notable achievements, the move from fee-for-service to fee-for-value has been slow. However, unexpected circumstances have the power to accelerate change and, for the healthcare industry, COVID-19 has been the catalyst value-based care needed.

How the pandemic pushed healthcare forward

With elective or low priority procedures paused for months, high-volume specialties could not bring in the revenue health systems traditionally rely on. Simply put, they had to find other ways to get paid.

As described in Healthcare Finance, “Orthopedic procedures were down by 90%, according to Dave Terry, CEO and founder of Archway Health. Oncology was down by 20% because cancer procedures could not be put on hold as orthopedic procedures could.”

However, providers in value-base care arrangements were still bringing in steady returns – and leadership (and our government) took notice. In fact, Congress included value-based payment incentives within the COVID-19 relief bill for organizations to participate in models such as accountable care organizations.

Out of necessity, telehealth boomed in 2020 to continue the care patients needed and support hospitals’ dramatically-impacted bottom-lines. . The CDC reports there was a 154% increase in telehealth visits during the last week of March 2020 alone and, as the year continued, sustained increases in telehealth visits compared to the year prior.

This trend is unlikely to be curbed, not only for the financial protections it provides, but because care coordination is streamlined, and we anticipate data will show, patient outcomes are often improved.

2021 will continue the move to value-based care

In addition to what has been learned from COVID-19, there are a few additional factors that make a continued move to value-based care in 2021 likely.

Firstly, President-elect Joe Biden is known as an advocate of the Affordable Care Act (ACA) that began the initial push toward fee-for-value. Healthcare and political analysts anticipate his administration will prioritize new payment models. 

For example, they predict a reduction in the number of programs but having fewer, larger programs that are mandatory – such as bundled payments.

In addition to governmental incentives, healthcare organizations continue to seek the quadruple aim – enhancing the patient experience, the clinician experience, lower costs and improving outcomes. Inherent in this effort is value-based care.

Value-based care models avoid costly and unnecessary patient encounters (lowering costs), prioritize population health management and improving access (improving outcomes and patient experience), and streamline workflows that allow providers to spend more time caring for patients and less time on administrative tasks (improving clinician experience).

As healthcare organizations think strategically about improving clinical and financial outcomes, moving forward with value-based care is likely to be an organizational priority.

Clinical Collaboration Platforms help healthcare organizations lower costs and improve outcomes. Learn more about the value of a communication platform that helps you achieve the quadruple aim by reading our whitepaper, Making the Case for a Clinical Collaboration Platform.
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