Value-based care

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Note from the editor

The U.S. healthcare industry has slowly been transitioning to paying for value instead of volume in recent years. Many private payers and providers have championed the move, even introducing their own alternative payment programs, while some have held off on adopting value-based models, preferring instead the lucrative, costly fee-for-service status quo.

Now, in 2021, federal officials characterize the movement as at a pivotal crossroads. Roughly one in five payments is tied to some sort of quality model, and that's only projected to increase. But some leaders on the value-based frontier worry the coronavirus pandemic might be delaying this sea change as providers, following months of shrunken margins and fluctuating volumes, look for ways to recoup revenue quickly and sustainably.

Doctors in value-based arrangements like accountable care organizations assume financial risk — a scary proposition given the uncertainty of the times. But as medical costs continue to skyrocket, others hope the pandemic nudges providers to adopt value-based care as they look to diversify revenue streams, bringing the movement back on track.

Rebecca Pifer Reporter

Value-based care at 'critical juncture,' new CMMI chief says

• Published April 20, 2021

CMS pushes back kidney care payment model start date to January 2022

• Published March 10, 2021

Could coronavirus derail the decades-long shift to value-based care?

• Published April 15, 2020

As SDOH efforts take off, payers try to carve out their role

• Published Feb. 12, 2020

Pandemic prompts CMS to drop some reporting requirements for value-based initiatives

• Published March 23, 2020

BCBS of Michigan cuts new value payment deal with 7 major systems

• Published Dec. 16, 2019

MA value-based plan enrollment tripling for 2020

• Published Dec. 20, 2019

Despite pop health buzz, few providers screen for social needs

• Published Sept. 19, 2019

The evolution of value-based care

The U.S. healthcare industry has been slowly transitioning to paying for value instead of volume over the past decade. As medical costs continue to skyrocket, the question is whether the pandemic will be the final push for providers to adopt value-based care.

included in this trendline
  • Could coronavirus derail the decades-long shift to value-based care?
  • BCBS of Michigan cuts new value payment deal with 7 major systems
  • Pandemic prompts CMS to drop some reporting requirements for value-based initiatives
Our Trendlines go deep on the biggest trends. These special reports, produced by our team of award-winning journalists, help business leaders understand how their industries are changing.
Davide Savenije Editor-in-Chief at Industry Dive.