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Value-Based Medicare Advantage Payment Plans ‘Only Going to Increase’

September 7, 2021Amy StulickNo CommentsSkilled Nursing NewsMedicare ACOs/MSSP,Alternative payment models (APMs)

There’s a strong possibility that Medicare will move to mandate value-based payment models (VBP) for the nursing home industry in the years to come, according to industry executives.

Dr. René Lerer and Brian Cloch, CEOs for Longevity Health Plan and Transitional Care Management, respectively, spoke at a panel on the future of VBP models during Skilled Nursing News’ RETHINK event last week.

Lerer pointed to his time at Florida Blue as a precursor to his thoughts on broader usage of VBP models.

The payer required 50% of all Medicare Advantage payments be value-based, a sentiment that is “only going to increase,” Lerer said.

Another evolutionary trait of the model, Lerer added, is the role of long-term care more closely aligning with the role of a primary care doctor.

“It can be the equivalent of the primary care doctor. [Long-term care facilities] drive that patient’s care, in my mind, and I’m a physician, more than the doctor does,” said Lerer. “In many places, they have 100 patients and 30 doctors, and those doctors are not doing what they need to do, and the building controls that.”

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: Medicare, Medicare Advantage, Medicare Advantage payment plans, nursing home industry, nursing homes, value-based care, value-based payment models, vbc, VBP

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