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Your health care organization may be on the tightrope of still coping with COVID-related illness and delivering essential patient care, amidst staffing and supply shortages. But in 2022, life is not poised to give health care a breather. Likewise, there is no slow-down to the expansion of Value-Based Care and payment models or development of further stages in 2022.
This year, providers in traditional Medicare will rack up stiffer penalties if costs are higher than CMS algorithms calculate. More ACO providers will progress along the path to Risk, and more will participate in alternative payment models (APMs). This will be the case especially for Direct Contracting and Primary Care First for primary care groups and the Kidney Care Choices (KCC) or similar models for specialists. Mandatory payment models, CMS has strongly suggested, are coming.
As you move forward with value-based strategies, however, you may not expect that a very significant group could derail the success of your efforts: consumers. Consumers are, in large part, directing how the pandemic continues to unfold. Their choices to vaccinate and take other actions to protect themselves and others—including you—are not much different than how they act when you are treating them as patients. But recognizing their enormous leverage as they move in and out of your system is key to your ultimate success in Value-Based Care.
This article will explore three key areas where consumers have momentum to directly affect your ability to succeed under Value-Based Care. Our next post will itemize strategies you can use to fortify your organization with consumer-directed strategies.