In a recent podcast, Physician’s Weekly (PW) spoke with Kim Yu, MD, FAAFP, about how PCPs can minimize the burden on their practices during the transition from fee-forservice to value-based care.
PW: What is value-based care?
Dr. Yu: Value-based care is the concept that physicians should be reimbursed based on patient outcomes instead of the volume of services provided. In value-based care arrangements, clinics, community health centers, and hospitals contract with payers to care for a defined set of attributed patients. The goal is to help patients maintain the highest possible level of wellness rather than waiting to provide care when patients get sick.
How can clinicians implement value-based care more easily?
CMS wants most patients on Medicare feefor-service plans to transition to a value-based care relationship, with accountability for quality and total cost of care, by 2030. We’re talking about millions of patients. Physicians will either adopt value-based relationships or risk being left behind.
To make the transition to value-based care less burdensome, you must prioritize workforce, data, and resources. Make sure to educate your team about why you are making the shift. It is also critical to have data from the point of care. Then, you can build resources (eg population health tools, increased finances, a certified EHR, or community health workers) to transform the way you practice. Do you think we will see more policy shifts? Will value-based care mostly affect primary care? I anticipate that we’re going to see improved, increased adoption of value-based care and alternative payment models in every payer space. Population health ideals, such as better health and lower costs, will become pivotal in everyday vernacular. However, there are also some risks with valuebased care. My biggest concern is that I don’t want any patients left behind. We shouldn’t be determining which patients to care for to make our numbers look great and keep costs lower. It’s important to have policies and procedures in place to protect marginalized patients from this kind of cherry picking. I also see a threat to independent primary care. Large systems are buying or making partnerships with value-based care organizations and then purchasing independent primary care practices. On one hand, this relieves the practice’s burden of having to pay bills. On the other hand, it decreases their ability to have control over the patient-physician relationship.
