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The Centers for Medicare and Medicaid Services (CMS) has set an ambitious goal to fully transition from fee-for-service models to value-based care by 2030. However, according to Anders Gilberg, Senior Vice President of Government Affairs for the Medical Group Management Association (MGMA), this shift will require significant effort and face numerous obstacles, as he told HealthExec in a video interview.
CMS has long sought to transition to value-based payments, where providers and hospitals are compensated for episodes of care addressing specific health issues, rather than the “nickel-and-dime” approach of paying for every test, procedure, device, or disposable item used. Under the value-based model, hospitals and providers will assume more risk by receiving a lump sum for care, with an economic incentive to streamline care and reduce costs.
Gilberg outlined the challenges involved in such a large-scale transformation. While the healthcare system has made strides toward value-based care over the last decade, he emphasized that progress has been slow, and there is still considerable work to be done.