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Trump May Slow, Not Stop, Transition to Value-based Care

Analysis  |  By Debra Shute  
   November 17, 2016

With the tremendous uncertainty over the ACA repeal, the appetite for the value transition will probably slow for a great swath of the industry.

However, a lot of our members are still moving forward because they've already enrolled as a Next Generation ACO, the Medicare Shared Savings Program, or they have commercial contracts with some sort of value component.

As far as MACRA is concerned, it's still statute, which reflects that Congress and CMS want to move ahead on this thing called value.

HLM: Historically, private payers follow the government's lead. Do you think we'll see a shift in that pattern?

Speed: It's interesting. Commercial payers do follow Medicare, typically, but we have conflicting ideas to consider.

On the one hand, when I think about the risk survey we conducted last year, it was clear that our members were engaging with commercial payers on commercial ACOs more than federal ACOs because, frankly, with commercial payers the negotiations tend to be easier.

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Commercial payers aren't regulating them like CMS, so they just want to create products that make sense for both sides.

On the other hand, I wouldn't say the commercial payers are offering a lot of risk products in the market right now. I think one of the issues our members have is that commercial payers aren't offering enough products to continue with this value transition.

So as far as the value proposition, all providers and payers have to get together and decide how both are going to be successful in risk, because I think that transition was slowing even before Trump was elected.

The on-demand HealthLeaders Media webcast, How the 2016 Election Will Affect the Future Landscape of Healthcare Payment and Policy, offers more information on healthcare policy, payments, and politics.

Debra Shute is the Senior Physicians Editor for HealthLeaders Media.

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