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It’s no secret that something needs to be done in order to curb the unsustainable increase in Medicare spending. In 2021, overall Medicare cost grew 8.4%, or 21% of total national health expenditure, greatly exceeding the pace of economic expansion and in turn threatening the long-term financial viability of the program. The Centers for Medicare & Medicaid Services (CMS) believes that value-based healthcare delivery will decrease costs and improve outcomes and has promised additional models this year to continue the shift from traditional fee-for-service models. Although the industry has started to incorporate proactive care delivery and collaborative strategies like interoperability, providers have been slow to adopt value-based care in part because of revenue uncertainty.
In a new bipartisan bill, the U.S. Senate proposed a 2-year extension on the 5% bonus to providers that participate in alternative payment models. This move is an important one to prevent value-based care (VBC) program attrition, but additional steps are needed to further incentivize provider participation. In lieu of new policy that will increase bonuses and revenue, providers can take strategic measures at the organizational level to put themselves in a position that rewards them financially and reciprocally for the risk they assume in value-based care.