The Duke-Margolis Center for Health Policy https://healthpolicy.duke.edu and West Health https://www.westhealth.org are going to collaborate on a three year research initiative to advance and accelerate value-based payment reform in the U.S healthcare system.
Despite significant progress to implement new models over the past 10 years, barriers remain at both the state and national levels, which means most care is still driven by fee-for-service payments that have produced only modest cost savings. To guide the initiative, the Duke-Margolis Center and West Health have produced two roadmaps.
The two Roadmaps identifying critical action areas for the next phase of payment reform include:
- The National Roadmap focuses on implementing value-based payment models by expanding opportunities for specialists, reducing or eliminating low-value care, increasing opportunities for consumer engagement, and improving treatment for the seriously ill
- The State Roadmap focuses on the unique ability of states to develop payment models best suited for the needs of their healthcare system. The Roadmap offers guidance focused on how to make the case for value-based care, identify and implement new payment models, strengthen data analytic capabilities and infrastructure, and develop supporting policies throughout the healthcare system
Over the next three years, Duke-Margolis and West Health will carry out a wide range of projects designed to build on the recommendations for this work. The initiative will also address core issues surrounding COVID-19, plus offer webinars and other learning sessions to support state and organizations alike.
Go to https://healthpolicy.duke.edu/news/west-health-partnership-accelerate-value-based-care to download A Roadmap to Accelerated National Value-Based Payment Reform: Filling in the Missing Pieces and A roadmap for Effective State Leadership in Value-Based Payment Reform.
In addition, The Duke-Margolis Center for Health Policy has released the document Supporting Health Care Providers During and After the Pandemic: A COVID-19 Health Care Resilience Program. Dealing with COVID-19 has made it necessary to develop new payment approaches to help healthcare providers during and after COVID-19. Clinicians, hospitals, and other healthcare providers are being called upon to not only support critical efforts to contain the pandemic, meet the demand for needed services delayed during the pandemic, the need to redesign care to protect high risk individuals, and improve care for the future.
Meeting these healthcare needs are extremely challenging for most providers because of steep declines in FFS revenue. While many providers have implemented an unprecedented increase in telemedicine visits, this has only partially offset significant revenue reductions.
These financial difficulties have been particularly challenging for primary care, mental health care, and many specialists, as well as providers in rural areas serving individuals on Medicaid or without insurance. Despite substantial Congressional relief spending, providers are receiving only limited support for modifying their care models.
To provide the solution, the two part A COVID-19 Health Care Resilience Program would begin with upfront payments and potential COVID-19 loan forgiveness while being linked to providers transitioning to non-FFS alternative payment models in the near future.
These upfront payments would enable providers to strengthen the healthcare response to COVID-19 now, while participation in future alternative payment reforms would increase confidence in needed investments that are not presently well supported in FFS and will be financially viable.
Go to https://healthpolicy.duke.edu/sites/default/files/atoms/files/covid19_health_care_resiliance_one_program_summary-final.pdf for more information on the Resilience Program.