Study: Great potential for Medicare Advantage to engage providers in value-based care

While Medicare Advantage presents immense potential to accelerate the transition from volume to value in the healthcare industry, health plans still face challenges in convincing providers of the buisness case for value-based care in MA, according to a new study from Deloitte.

The Deloitte study examined what extent health plans participating in MA use it to test value-based care arrangements, as well as determine what barriers they may encounter.

The study revealed four major themes about value-based care in MA:

  • Most value-based arrangements in MA are in the experimental phase, with nearly all surveyed health plans and providers having some kind of value-based care in place for their Medicare populations. Patient-centered medical homes were the most common.
  • Even though value-based care strategies are similar in the commercial and MA line of business, health plans see greater value in MA.
  • MA value-based care strategies are influenced by federal policies, initiatives and regulations.
  • There are challenges that health plans and providers have to overcome, as many of the health plans surveyed said they struggle to identify the right provider partners and work with them effectively.

The Centers for Medicare & Medicaid Services (CMS) is currently the largest supplier of value-based contracts for providers, the report says, and most such activity is in traditional Medicare. Many provider respondents--65 percent--believe that participating in value-based programs with CMS will help them succeed in value-based arrangements with health plans. Additionally, 55 percent say that value-based care arrangements with health plans will help them be successful with CMS. That said, however, health plan respondents also feel that federal regulators could do more to encourage greater adoption of value-based care.

CMS has said its ability to move to a value-based system depends on receiving data from health insurers to improve care delivery. Still, strides have been made to shift to a value-based system, including healthcare partnerships with a service provider that integrate social services into healthcare.

"Most respondents are optimistic about the future of [value-based care]," the report revealed. "They believe that collaboration is the way forward, with technology and data serving as key enablers."

To learn more:
- read the full Deloitte study (.pdf)

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