One of the surprising outcomes of COVID-19 this past year is how it has helped move healthcare delivery towards value-based care. That is expected to continue and increase in 2021.
During uncertainty, instead of moving back to the security of the old fee-for-service model, providers saw the benefit of moving down the path to value.
As more than one expert has said, if you were counting on fee-for-service to get paid during the pandemic, you weren’t getting paid. If you had a value-based arrangement, you were still getting paid.
Orthopedic procedures were down by 90%, according to Dave Terry, CEO and founder of Archway Health. Oncology was down by 20% because cancer procedures could not be put on hold as orthopedic procedures could.
Providers in shared value arrangements for orthopedics had a steady cash flow of about $160 per member, per month, according to Terry.
“We’ve seen a lot of providers start to say, ‘How do I tap into that?'” Terry said. “Provider interest is increasing. In 2021, we’re still quite excited about the movement to value-based care. We felt that way pre-COVID; 2020 was a bit of a pause. Going forward, we’re seeing a number of things accelerating movement to value-based care.”
The National Association of ACOs recently praised the work of Congress for saving value-based payment incentives by including a provision in the COVID-relief bill to encourage continued participation in risk-bearing alternative payment models like accountable care organizations.
Congress did this by freezing thresholds needed to secure a 5% bonus on annual Medicare payments. A survey earlier this year from NAACOS found that 96% of the 216 ACO respondents would not meet the 2021 thresholds based on their performance in 2020.
At some point this decade, Medicare spending will top $1 trillion per year. As policymakers look for ways to lower the rate of spending growth, ACOs have become the leading mechanism, according to NAACOS.
With President-elect Joe Biden taking over the White House, support for the Affordable Care Act will grow. Other than sending in a legal memorandum in support of the ACA,
Biden can do little to change the outcome of the Supreme Cou