Healthcare leaders to Trump: Don’t stop the push for value-based care

The 2016 U.S. presidential election is concluded, and we are left with a new leader and a country still divided. But hotel operators are taking a swing at optimism.
Big-name health systems and insurers were among the 117 organizations that signed a letter to President Donald Trump and Vice President Mike Pence, urging them to support efforts to transition away from a fee-for-service model to value-based care.

Dozens of leading healthcare organizations have called on President Donald Trump and Vice President Mike Pence to continue the federal government’s push to value-based, patient-centered payment models that reward providers for improved quality and cost-effective care.

Big-name health systems and insurers, including the Cleveland Clinic, Dignity Health, Trinity Health, Anthem and Blue Cross Blue Shield Massachusetts were among the 120 organizations to sign a letter (PDF) to Trump and Pence, urging them to support continued efforts to transition away from a fee-for-service model.

Healthcare invested in value-based care

The movement to value-based payment models, a bipartisan effort, began 15 years ago with pay-for-performance, bundled payments and accountable care organization models. And healthcare providers, clinicians and insurers invested heavily to move healthcare in this direction, noted Premier, an alliance of 3,750 hospitals and more than 130,000 other provider organizations, in an announcement about the letter.

The movement, Premier said, is finally starting to generate results, pointing to Medicare ACOs savings of $1.29 billion since 2012 while improving quality.

“Through private and public sector alignment, the move toward value-based care is succeeding, measurably improving healthcare quality and contributing to historically low costs. Now is not the time for policymakers to signal a shift away from value-based care, either through action or inaction,” they wrote in the letter.

10 health policy principles

To build on the momentum, the organizations said they have a vision for a modernized, sustainable healthcare system based on 10 principles:

  • Empower and engage patients to make healthcare decisions with information and support from their healthcare team.
  • Invest in engaging patients in the development of measures of provider performance that are relevant to them and consistently and transparently reported by all public and private payers.
  • Improve clinician and provider access to timely, accurate and complete claims data to better facilitate care management.
  • Recognize that the socioeconomic status of many patients creates challenges in providing care, and adjust payments to providers as appropriate.
  • Design voluntary payment models that incent greater participation and achieve the highest quality and cost value based on patient choice and competitive markets.
  • Expand the use of waivers from fee-for-service legal and regulatory requirements that impede collaboration and shared accountability, while preserving consumer protections and safeguards against fraud.
  • Build on and expand payment models that promote collaborative financial and care coordination arrangements using incentives that align payers, healthcare providers, providers of long-term care services and clinicians.
  • Appropriately incent access to medical innovations and treatments that hold the potential to improve quality of care and reduce overall system cost.
  • Promote public and private investment in the transparent, evidence-based testing and scaling of new alternative payment models as directed in MACRA so that clinicians, other healthcare providers and payers can learn how payment models work and evolve in the clinical setting.

“Despite all that we’ve managed to do, healthcare is increasingly unaffordable–for families, for businesses and for taxpayers,” John Rother, president and CEO, National Coalition on Health Care, said in the announcement.  “Even in the relatively stable employer-sponsored insurance market, deductibles are climbing and the average premium for a family plan has topped $18,000 a year. If we are to have any hope of taming these increases, we must accelerate, not slowdown, the transition from volume to value.”