01.13.2020

Industry Voices—What does the value equation look like in the new decade?

As healthcare leaders look to the year ahead, many predict that this will be the year the training wheels come off value-based care. This is not a new priority, but the move from value-based theory to practice remains one of the industry’s top challenges.

Healthcare costs are expected to rise by 6% in 2020, largely driven by increased prices, not utilization. Even as more states mandate value-based care for Medicaid and Medicare expands bundled payment options, making meaningful progress toward improved quality at reduced cost has taken longer than expected.

The problem is that the reward for success under value-based models is too far separated from the action. Physicians and healthcare organizations aren’t seeing real-time reinforcement for positive behavior. So often, providers are given 12 months to manage the health of a population, only to wait six months longer to be compensated for gains around cost and quality. Without timely feedback and incentives, maintaining momentum for value-based behaviors becomes difficult. It’s also challenging to determine which actions make the biggest difference.

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