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Experts believe value-based care won’t ever reach scale unless fundamental barriers are addressed — including voluntary models, misaligned payer incentives, excessive metrics and weak employer engagement.
The way healthcare is paid for is one of the most powerful levers shaping the future of the industry. Reimbursement structures determine which treatments are offered, how clinicians spend their time and even which innovations make it into everyday practice.
As value-based and alternative payment models gain traction, there is growing potential to move beyond fee-for-service incentives that reward volume over quality. Yet despite progress, significant challenges persist. During the Digital Medicine Society’s Healthcare 2030 Summit in Washington, D.C. last week, healthcare leaders discussed the fundamental problems they think are preventing alternative payment models from reaching scale and achieving success.
Many new payment models are struggling to balance risk with adequate support, which leaves some providers wary. There are also gaps in interoperability and standardized quality measures that can hurt the success of even the most well-intentioned programs.