Challenges to Reaching a Value-Based Care System

Several barriers to value-based care exist, including finances and cost, meaning both the financial investments required by small- and mid-sized provider groups and the size of corresponding incentives.

Problems in health care seem overwhelming, with at least 17 different factors cited as driving unsustainable spending, according to a presentation at the Academy of Managed Care Pharmacy’s Managed Care & Specialty Pharmacy Annual Meeting held April 23-26, in Boston, Massachusetts.

Two executives from Precision for Value LLC, Jorge Fant, MPH, and Elizabeth Oyekan spoke about “Charting the Shifting Value-Based Healthcare Landscape: Emerging Developments for 2018 and Beyond” and offered advice about what healthcare companies can do to succeed.

Fant described the healthcare landscape as “the perfect storm for change.” The question is, he asked, who is going to make the push to make it happen? He reviewed early attempts that left many dissatisfied, from initial payment bundles, to commercial pay for performance programs, to newer narrow network programs, which are not yet mainstream.

“There's a lot to believe that the managed care industry has failed us,” he said. But he thinks the industry may have reached the “tipping point” to value-based care, with heavy credit given to the ultimate payers: government and employers.

He noted several barriers to value-based care, including:

  • Technology and analytics, where interactive interoperability means not just getting the data but being able to analyze it.

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