Payers need to be ready to help providers with technology and resources to help push them toward taking on upside or downside financial risk as a part of value-based care, the head of insurer Humana said.
“Not everyone is ready, whether it is their systems, their risk tolerance to their ability to comprehend what it means,” said Bruce Broussard, CEO of Humana, during the Health Care Payment Learning & Action Network Summit in Washington Thursday.
Broussard’s comments come as both commercial and government payers are trying to boost the transition to value-based care that pays providers based on outcomes instead of traditional fee-for-service.
Humana aims to support advanced payment models with technology to allow providers to access information traditionally in the electronic medical record and claims systems to help manage that risk at their level, Broussard said.
He added the organization offers staff and other resources to help organizations figure out the data if they need help.
“We don’t want to do what was done in the nineties which was we give them a contract and say go do it,” he said.
Training the provider on value-based care is another major obstacle.
“What we have discovered is medical schools and training programs are training docs for fee-for-service,” said Christopher Chen, CEO of primary care provider ChenMed, at the summit. “They go out into the community and practice fee-for-service.”
Chen said it can take four to five months to “deprogram” a physician from fee-for-service methodologies and another four to five months to reprogram them on value-based care.
“You need the right training and platform,” he said.
Another issue is how to transition massive health systems to value-based care, which can be more difficult than smaller practices, Broussard said.
A primary care doctor that has six seats in his or her reception area is a “lot easier to change than having 4,000 beds that you got to keep filled,” he said. “How can we help those institutions make that change?”
The comments came after Department of Health and Human Services Secretary Alex Azar reiterated the Trump administration’s commitment to transitioning to value-based care.
“We need to tackle this challenge on every single front, transforming payments on every corner of our healthcare system,” he said.