The healthcare industry’s movement away from fee-for-service care models and toward value-based care has been an incredibly gradual process. Contracting in these arrangements remains difficult for providers and payers, and clinicians continue to struggle with the administrative burden that comes along with delivering value-based care.
Three healthcare experts shared their thoughts on this issue last month during a panel discussion at the 3rd Annual Summit on the Future of Rural Health Care in Sioux Falls, South Dakota.
“Everybody keeps talking about value-based care. [They say] ‘We’re going to go to capitation. We’re going to do value-based care,’’’ said Eve Cunningham, chief of virtual care and digital health at Providence. “When you’re a health system that’s on the fee-for-service hamster wheel, it’s really hard to pivot to value-based care — so you get this little sliver of capitation that you kind of break off. Everybody keeps talking about it, and we keep saying it’s here, but the actual transformation hasn’t come.”
Cunningham noted that throughout her career, she has witnessed many providers attempt to adopt value-based care models. Her main observation is that the transition to value-based care is greater than simply taking on financial risk and going through a new contracting process — it requires providers to get their clinicians to practice differently.
“If you don’t give them the tools to practice differently in a value-based care environment, or the training or the support, you’re not going to be successful,” she declared.
Switching to a value-based approach usually results in increasing clinicians’ responsibilities for documentation, care coordination, patient engagement, preventive care outreach, and the tracking of financial and population health metrics.
Adam Berger, operating partner at WindRose Health Investors, highlighted the complexity of the objectives that providers are expected to achieve.
He noted that value-based care arrangements often require providers to tackle multifaceted challenges, such as how to close care gaps or improve patients’ social determinants of health.
“Whatever it is that we are asking the provider to do, it’s going to be a lot of work to get there,” Berger stated.
Success in value-based care also requires the right tech infrastructure, he added.
Providers looking to thrive in value-based need the right technology running in the background to integrate data from various sources, Berger noted. This means having systems in place that not only move data efficiently but also deliver insights at the point of care, allowing providers to make better decisions to improve patients’ outcomes, he said.
Another panelist — Nworah Ayogu, head of healthcare impact at Thrive Capital — agreed with Cunningham and Berger. He said that many leaders in the healthcare industry have a habit of only talking about reimbursement when it comes to value-based care.
“We treat it like it’s always reimbursement. We don’t think about compensation, we don’t think about operations and infrastructure, and we don’t think about culture and practice patterns. That’s why it fails: because it is a four layer cake, and all we do is icing,” Ayogu remarked.
Photo: Carlina Teteris, Getty Images
