How Payers Can Move Providers Along Value-Based Care Continuum

Health Payer Intelligence
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How Payers Can Move Providers Along Value-Based Care Continuum

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In this Health Payer Intelligence article, you'll learn about:

  • Offering payment support to providers

" Transformation payments are vital to transitioning providers into more advanced payment models. When entering into a value-based care model, providers may have to cover care coordination costs, practice transformation costs, and other expenses.

Per member per month payments from payers alongside bonuses for positive performance can be essential to a provider’s progress in those early stages of the value-based care continuum, Powers said. "

  • The importance of primary care in the VBC model

" An essential piece of transitioning providers into value-based care is primary care transformation. For a primary care practice that has traditionally relied on fee-for-service reimbursement to meet value-based care performance metrics, changes will have to occur.

“We are seeing evidence in this analysis with those avoidable utilization metrics that the practices that are engaging in value-based payment models, at least in our experience, are changing the way they deliver care in a way that really impacts patient outcomes,” Powers shared. "

  • Future of value based care research

" There is a lot to glean from studying value-based care changes at the practice level, Powers added. In particular, the industry should apply more effort to understanding transformational strategies in high-performing practices.

“If we can learn more about what works best from the performers, then we as a payer—and then the community more broadly—can think of ways to target fee-for-fee programs or target specific models along that continuum that may help less advanced providers in value-based care make investments in the right areas,” Powers shared."

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