The Road to Value

This comes from an article in Modern Healthcare:

The shift to value-based payment stalled in 2017 largely because of decisions made by new CMS leadership and distractions caused by efforts to repeal the Affordable Care Act, health quality experts say.

And this is a bad thing?  Here’s more:

Over the last year, new CMS Administrator Seema Verma touted an agenda that supported value-based payment but also focused on ways to reduce administrative burden for clinicians. As a result, the Trump administration slowed down the implementation of Obama-era mandates intended to move the dial on value-based payment.

Move the dial?  That dial was going in an unproven direction.  Actually, it was going in a direction that was proven wrong.  Quality metrics and pay-for-performance have failed miserably.

Feel free to read the rest of the article but here is my favorite part:

Francois de Brantes, vice president and director of the Center for Payment Innovation at the Altarum Institute, said there currently aren’t many payment models for providers to try out.

“(Right now) we have two different flavors of advanced APMs. The vanilla flavor is the total cost of care, or ACOs, and the chocolate flavor is bundles, and that is it,” de Brantes said. “More flavors should be tried out. It is OK to innovate around payment because there all these different types of populations.”

What the hell does that even mean?

Forget flavors.  Forget payment innovation.  How about finding a transparent way for patients to pay for their care that inspires them to shop around and bring the price down? That’s the road to real value.

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Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected]

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4 Responses

  1. Kurt says:

    “Forget flavors. Forget payment innovation. How about finding a transparent way for patients to pay for their care that inspires them to shop around and bring the price down? That’s the road to real value.”

    ………………………….And encourages people to take better care of themselves. This “value” payment system isn’t worth shit. Try paying the patients and maybe they’ll listen to the doctors if they
    find out they’ll get paid for it or be given discounts on care.

  2. Perry says:

    Good grief. Why muck around with all these idiotic non-proven payment schemes. How about just paying docs for their time, like lawyers and accountants. For Pete’s sake, we are professionals!

  3. RSW says:

    From their web site:

    “Altarum demonstrates and is sought for leadership in identifying, understanding, and solving critical systems issues that impact the health of diverse and changing populations.  Altarum is acknowledged as a valued, collaborative, and collegial institute of the utmost competence and integrity.”

    I couldn’t read any more.

    Happy New Year!

    • Steve O' says:

      There are actually mindless ‘bots that can be told to generate prose such as “Let’s leverage turn-key action-items!” and “strategize end-to-end networks for multi-level targets for optimizing best-of-breed solutions as we synergize user-centric metrics!” If you wish to get nowhere, there are many paths.

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