The Pace of Healthcare Transformation to a Value-Based System

The ACO & Emerging Healthcare Delivery Coalition will meet again October 20-21, 2016, for the 6th live meeting. At the event, held in Philadelphia, Pennsylvania, attendees will hear presentations from industry leaders, participate in workshops, and listen to a panel discussion—like the one presented here—that takes a broader view on the changes in healthcare in the United States. Here is a segment from the panel discussion that was presented at the spring live meeting. Register now for the fall live meeting. Or become a member of the Coalition.

More insurers are moving towards alternative payment and delivery models, but the transition needs to happen a lot quicker, explained Michael E. Chernew, PhD, the Leonard D. Schaeffer Professor of Health Care Policy and the director of the Healthcare Markets and Regulation Lab in the Department of Health Care Policy at Harvard Medical School, in a panel discussion.

The discussion took place during a session at the ACO & Emerging Healthcare Delivery Coalition Spring Live Meeting in Scottsdale, Arizona, April 28-29. He was joined by panelists Patricia Salber, MD, MBA, executive officer of The Doctor Weighs In, and Bruce Sherman, MD, FCCP, FACOEM, medical director of Employers Health Coalition. The discussion was moderated by Clifford Goodman, PhD, senior vice president of The Lewin Group.

Chernew explained that alternative payment models and consolidation are the future of the healthcare system. Though plans are already moving towards payment reform through various mandates, Chernew stated that the transition needs to happen at a quicker rate because working halfway between fee-for-service and the new models is difficult to manage.

From an employer perspective, Sherman added that many organizations have shown great interest in alternative payment and delivery models by contracting with accountable care organizations (ACOs) or centers for excellence to achieve care models unlike the ones previously demonstrated in fee-for-service models.

“I think we’ve got an interesting dynamic among employers,” Sherman said. “Some are falling into the ACO camp. Others are saying, well, I’ll use my health plan and we’ll figure out what those high performance networks look like…”

On the other hand, Salber believes the transition to a completely value-based system is going to take a lot longer than expected, as ACOs are still in its early stages of figuring out what methods are going to be most successful.

“I think the ACOs are still trying to figure out how to actually be successful and make money,” she said.

Salber added that the rising cost of pharmaceuticals is another piece of the emerging care model puzzle that has yet to be figured out.