The August 17, 2021 session of Duke Medicine LEADS featured Kevin Shah, MD, MBA, presenting, "Health Care Finance and Payment Reform: How Do We Do That?"
Here are pearls and takeaways from the session:
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Health care spending represents 1/6th of the US economy. Fifty percent of health care spending tracks directly to hospitals and physicians; any effort to reduce health costs must necessarily address payments to doctors and hospitals.
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The pivotal policy behind value-based care was The Medicare Advancement and CHIP (Children’s Health Insurance Program) Reauthorization Act (MACRA) of 2015. This was a strongly bipartisan endeavor, meaning that value-based care has strong bipartisan support and is likely here to stay.
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Reimbursement models in value-based care represent a continuum. Most medical organizations are currently operating within a spectrum of payment models ranging from value-based incentives to risk sharing, where providers assume partial financial risk.
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Quality Improvement initiatives can improve adherence to value-based care. Transparency in practice patterns can be a simple initial step in aligning providers to a practice standard.
Duke Medicine Learning, Education, and Discussion Series (LEADS) takes place each Tuesday at 12 p.m. Learn more and see schedule of upcoming sessions.
