Despite the efforts and good intentions of many stakeholders, the healthcare system in the United States continues to struggle with rising costs and an imbalance of quality and access to care. In fact, approximately 90% of today’s healthcare market is a comprised of a model, which treats patients through a disparate network of providers on a fee-for-service basis. Why should you care and what does this mean?
Healthcare expenditures represent one of the largest components of the annual budget for the State of Missouri as well as one of the greatest expenses for most companies. Therefore, every citizen is a stakeholder in our country’s healthcare delivery system and has a vested interest in its direction. Despite the new Trump administration and its initiatives, there are healthcare changes in motion that will impact who provides your care, how it will be provided and how it will be paid. These include: 1.) changes in reimbursements through Medicaid, Medicare and private insurance companies, 2.) the demand for systemized sharing of patient health records across all levels of care, 3.) the continued advancements of healthcare technologies.
In response to these demands for change, the largest payers of healthcare in the United States – the Centers for Medicare & Medicaid Services (CMS) created valued based care programs. These programs deliver coordinated care through a network of providers who share patient information and drive cost down. CMS rewards healthcare providers with incentive payments for the quality of care they give instead of quantity.
Although healthcare providers in the State of Missouri have been at the forefront of establishing and implementing a variety of Value-Based Care network models, these issues are on the doorstep of healthcare organizations and executives, today. For example, as a healthcare technology provider, I have seen the reliance on technology increase in order to be competitive in the field as well as to provide the measurements necessary to receive the most reimbursements. Healthcare executives, owners, and administrators need to be educating themselves as to the changes taking place and how it will impact them now and in the future. As healthcare consumers, the general public needs to be aware of these changes because it impacts the delivery of their care. Knowing whether or not your healthcare provider is part of an Accountable Care Organization (ACO) can mean the difference in the transparency of care.
Authors: Laura Wasson from Tech Electronics and Joe Mulligan from Cain Brothers, are leading the initiative for change in the St. Louis healthcare industry. To provide more information these changes a summit is being held on May 10th — The Summit for Acute and Post-Acute Care Providers: Insights & Perspectives on Value-Based Care Delivery