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Physicians told Becker’s that the next major shift in medicine won’t be a new device or breakthrough drug, but the accelerating shift from fee-for-service to value-based purchasing.
Cost pressures, patient frustration and employer fatigue are converging in ways that may force a structural reset in how physicians practice and get paid, several said.
Steven Rich, MD, a geriatrician in Rochester, N.Y., said value-based purchasing will prove to be the greatest disruptor over the next five years.
“Fee-for-service still is the dominant paradigm for clinicians and health systems, but the runway is short, and the can cannot be kicked down the road much longer,” he said.
Dr. Rich pointed to the last time the U.S. meaningfully slowed healthcare spending growth — the HMO boom of the late 1980s and early 1990s. Though unpopular, he said, those models were built on “having broad-based, properly incentivized primary care physicians at the helm” who were empowered to manage cost and quality simultaneously.