Will New Value based Care Regulations Spark Innovation?

Keya Medical
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Will New Value based Care Regulations Spark Innovation?

Value-add innovation

In this Keya Medical article, you'll learn about:

  • The intention of new regulations promoting value based care

" Two important regulatory changes went into effect on Tuesday, January 19 to facilitate the shift to value-based care. These rules intend to modernize the Physician Self-Referral Statute (Stark)[1] and the Anti-Kickback Statute (AKS)[2] and make it easier to set up and administer value-based arrangements among healthcare services providers and those who pay for such services. "

  • New and modified safe harbors in the legislation

" These rules are intended to encourage arrangements in which providers and others coordinate the care of patients with other providers, share resources among themselves to facilitate better care coordination, share in the benefits of more efficient care delivery, and engage and support patients, without violating federal anti-kickback laws and self-referral regulations. However, these regulations should not be misread as a relaxation of the original intent of both Stark and AKS as guardrails against fraud and abuse. "

  • Where value based care impact innovation

" Under the traditional fee-for-service model, innovative technologies that improve care but do not have specific billing codes can struggle to attain financial viability. For good reason, payers are often reluctant to assign billing codes for new services until a body of evidence proving economic benefit is available. This process takes time and up-front investment. Because participants in VBEs share in savings (and potentially in losses), VBEs have an incentive to try new approaches faster. "

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