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
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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.
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Primary Care’s Dominance And Expansion
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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.
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Specialty Care And Innovation
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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.
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Future Challenges
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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.
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A Bright Future
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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.