Move toward value-based care will continue, provider survey shows

The future of health insurance in the U.S. may be deeply uncertain, but most health system leaders will continue to drive their organizations toward value-based care, a new leadership survey shows.

National healthcare advisory firm BDC Advisors talked with a dozen healthcare leaders in nine states over the time period when the American Health Care Act (AHCA) was introduced in the House in early March, withdrawn later that month, and then successfully passed in early May after several revisions.

“Leaders feel their organizations face many of the same challenges they did in 2011 when [the Affordable Care Act] was introduced: revenues not keeping up with cost growth is still an issue, quality and value remain ongoing concerns, and breaking even on government programs is still a challenge,” the survey report said. “While the potential capping of Medicaid funding and the fate of the Health Insurance Exchanges are wild-card issues, commercial insurance will remain the main avenue of growth, scale will remain critical, and the move towards value-based reimbursement will continue.”

The survey shows that providers are focused on moves that transcend the cloudy legislative and regulatory picture and instead address more fundamental economic forces, including:  

• Achieving scale through partnerships and alliances

• Commercial market growth (e.g., through targeted ambulatory expansion)

• Continued focus on Medicare Advantage

• Aggressive cost control

• Partnerships with health plans to share more risk

• Building the clinical network

• Slowdown or halt on long-term investments

The study authors, Aamer Mumtaz, Dr. Alan London and Dr. David Fairchild, conclude that “the organizations facing the biggest challenges will be providers with significant exchange and Medicaid business, and that cutbacks in these already low-margin businesses lines are likely to have a disproportionately negative impact on those organizations.”

As a result, they said, “there could be a slowdown of the momentum created by the ACA towards care coordination and value-based care initiatives.”

BDC Advisors surveyed healthcare leaders from Arizona, California, Florida, Louisiana, Maryland, Massachusetts, New Jersey, Ohio, and Pennsylvania.

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