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The Year That Was: A Reflection On Value-Based Care

As we bid farewell to 2023, we’re reflecting on value-based care delivery within our industry during the year that was.


Regulatory Forces And The CMS Vision


Regulatory initiatives, spearheaded by the Centers for Medicare & Medicaid Services (CMS), have driven the adoption of population-based payment models. Recent shared savings reports have bolstered interest in value-based care – and our announcement is coming out soon.



Physician Interest And Evolving Risk Appetite

 

Physicians have shown substantial interest in value-based care, and their evolving risk appetite is notable. The long-term prospects for value-based care remain favorable.


 

Primary Care’s Dominance And Expansion

 

Primary care has been at the forefront of value-based care, with significant deals in 2022 underscoring its significance. Optum’s acquisition of Kelsey-Seybold Clinic and Humana’s investment in CenterWell Senior Primary Care highlight the substantial attention and investment flowing into the primary care space, particularly within the Medicare Advantage space.

 


Specialty Care And Innovation

 

The extension of value-based care into specialty care, while slower, is gaining traction. Standardized interventions in orthopedics and cardiology have led to the growth of episode-based payment models. Examples in oncology and nephrology showcase the industry’s evolving interest in behavioral health within value-based care models, recognizing the connection between physical and mental health.


 

Future Challenges

 

Despite progress in interoperability, challenges persist, including concerns about data quality and infrastructure changes. The road ahead involves widespread adoption of value-based care, with a step-by-step approach emphasizing progress over sophisticated technology. Projections suggest that fee-for-value arrangements will capture a significant market share from traditional fee-for-service providers in primary care by 2030.


 

A Bright Future

 

As we conclude this reflective journey through value-based care, it is clear that the landscape is dynamic, promising, and filled with opportunities. Stakeholders, investors, and healthcare providers continue moving forward to shape a healthier and more accountable healthcare future.

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