Ready or Not, Leaders Prepare for a Value-Based Future

Bob Wertz, May 9, 2017

The future of the healthcare industry may be uncertain when it comes to Congressional action, or the lack thereof. But one concept that has been widely embraced for the past few years is the commitment of healthcare leaders to a value-based model for care and reimbursement.

This article first appeared in the May 2017 issue of HealthLeaders magazine.

Whether your politics lean left or right, there is near-universal agreement that fee-for-service, absent clinical and financial accountability, is untenable.

In our pre-inauguration Healthcare in the Trump Era survey of 535 healthcare leaders, only three people cited elimination of pay-for-performance and value-based purchasing in an open-response question that allowed them to cite the one government regulation they would kill if they could.

A similar mood was evident in late February at the HIMSS conference in Orlando. Executives with whom I spoke expressed confidence that the move to value-based care is here to stay.

Daniel E. Johnson, executive vice president of healthcare strategy at Experian, said that the megatrends in the industry are still moving forward. “For example, this move from fee-for-service to value-based care: That we don’t see being interrupted by the new administration.”

Likewise, OptumInsight CEO Bill Miller notes that payers and providers are investing in value-based efforts and won’t want to “put the genie back in the bottle” as the industry moves away from fee-for-service. From a value and consumerism perspective, he says, “if you’re the only one that wants to go backwards, and the rest of the industry’s going forward, you’ll die.”

In our May Intelligence Report, highlights of which appear in the current HealthLeaders, the data reveals that leaders have a positive appraisal when evaluating their organizations’ level of strength in preparing for value-based care. Nearly three-quarters say that their level of strength is very strong or somewhat strong for overall preparation for both value-based care delivery changes (73%) and value-based financial changes (72%).

But Pamela J. Stoyanoff, MBA, CPA, FACHE, executive vice president and COO at Methodist Health System in Dallas, and Lead Advisor for the Intelligence Report, offers a caution: “People think that they’re ready for value-based care, but based on some of the other survey results, I’m not sure they are.”

Indeed, while overall preparation gets high marks, the performance ratings for individual competencies reveal considerable variation. Only 47%, for example, characterize their longitudinal patient care as somewhat or very strong, and just 28% describe their staff’s actuarial skills for financial risk assessment that way.

The commitment is there, which is essential; the competency is mixed, which, at this stage, is to be expected.

Bob Wertz

Bob Wertz is editorial director for HealthLeaders Media. He may be contacted at bwertz@healthleadersmedia.com.

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