Providers that participated in value-based care generally fared better financially during the worst parts of the COVID-19 pandemic when non-essential procedures were largely on pause.
But while regulators hoped that the pandemic may spur more investment in value-based care, that is not the case so far, said Center for Medicare and Medicaid Innovation Director Liz Fowler.
“Coming out of the pandemic, everyone we talk to say there are still pressures in the system around the workforce,” Fowler said during an event in Washington Wednesday held by the Better Medicare Alliance.
Fowler said that providers that invested in value-based care were “more resilient and better able to withstand the precipitous drop in volume.”
Providers are still struggling with higher labor costs due to an industry-wide staffing shortage. A recent report from Kaufman Hall detailed how a majority of hospitals and health systems are not operating at full capacity due to staffing shortages.
Fowler said that these pressures could be influencing provider interest in moving to a value-based care program or model.
“We had hoped the pandemic might spur more investment in value-based care, but I think we need to be realistic about what providers are able to do,” she said.
The Centers for Medicare and Medicaid Services has proposed several options aimed at increasing participation in value-based care, including offering upfront investments to providers that generally serve rural and low-income populations and may not have the margins to set up a system.
The push to entice more providers dovetails with CMMI’s effort to improve health equity. This includes new requirements on providers to collect race, ethnicity and social determinants of health data.
The new ACO REACH model, which goes into effect in January and grants partially capitated payments to providers, will include for the first time a requirement for participants to create an equity plan that includes identifying health disparities and how to address them.
Fowler said that MA plans can also help with data collection and analysis.
“I think we see MA plans as important partners,” she said. Moving this ball down the field is not just important for the administration but for the whole healthcare system. Everywhere I go I’d say all stakeholders are focused on equity, but we have to be able to demonstrate what is working and what is not.”