Mike Fazio: APM Uptake Requires Helping Providers Understand How to Protect Against Risk

The industry does not do a very good job of letting providers know there are ways to cover risk or protect against it. Better educating physicians on this would help improve uptake of value-based care models, said Mike Fazio, senior vice president of client services, Archway Health.

Transcript

Studies have shown that providers don’t see alternative payment model uptake happening very quickly. What can be done to improve participation and move the industry more quickly to value-based care?

CMS does a great job at creating well-defined models that are, like OCM [Oncology Care Model] and BPCI [Bundled Payments for Care Improvement] Advanced. But they are complex and highly regulatory. So, understanding the rules and the complexity of the model takes a long time. And so, walking providers through that slowly, we found helps them understand and be willing to participate in something like a voluntary model like OCM.

And so, I think payers and employers could do a better job in following CMS’ lead in offering contracts like that to the market. And that’s been slow. They’ve kind of been on the sidelines and CMS has been leading the way with things like OCM. So, it’s getting practices and hospitals to understand what it really means to be in a model and it’s ok to walk slowly from a beginning and try not to make it too cumbersome to begin and usually that helps when you work with them to understand it.

And then the movement to risk is a big factor in participation. So, getting providers to understand that there are partners that they can work with to either cover that risk or protect against risk and risk mitigation tools is important so that it’s [not], “I can’t do this model because we can’t bear the risk or we’re not risk tolerant.” And so, I think the industry can just do a better job, at least on the vendor side with getting practices to understand those components of it.