The pandemic has definitely elevated suppliers’ appetites for value-based contracting. Three-quarters of survey respondents stated they plan to tackle extra value-based contracts on account of the disaster.
Early on within the pandemic, it grew to become clear that well being plans supplied a monetary buffer for well being techniques as a result of they generated regular earnings from premiums at the same time as income from surgical procedures and different patient-care companies plummeted. Furthermore, value-based contracts, which take many types however successfully pay suppliers to maintain sufferers wholesome reasonably than based mostly on the variety of companies they supply, emerged as smart options throughout instances of uncertainty.
Atlantic Well being’s value-based technique was its “saving grace” in the course of the pandemic, Gragnolati stated. The well being system’s contract with Horizon Blue Cross and Blue Defend of New Jersey options draw back threat, which requires being able to marry claims and scientific knowledge.
“That provides you a base of information analytics that’s spectacular,” he stated.
Atlantic Well being even used that knowledge to review how flu usually migrates in its communities to foretell how COVID would unfold. Gragnolati stated the predictions had been “spot on.”
Whereas only a few payers in Baylor Scott & White’s market provide capitated contracts, Hinton stated the pandemic has definitely accelerated the motion towards value-based care. That’s as a result of the federal authorities is answerable for extra sufferers’ care beneath public applications like Medicare and employers wish to drive their healthcare prices down.
“All these roads result in a continued discount of open-ended, fee-for-service reimbursement and extra experimentation within the realm of value-based care,” he stated.
The disaster has additionally spurred extra funding in outpatient amenities as some sufferers proceed to shrink back from hospitals. Half of respondents to the survey stated the pandemic has prompted them so as to add extra outpatient amenities akin to ambulatory surgical procedure facilities, urgent-care clinics and free-standing emergency departments.
Well being techniques have invested closely in ASCs lately as each insurers and sufferers push for cheaper choices, a current Fashionable Healthcare evaluation discovered.
Froedtert, for instance, has at all times been mild on hospitals for its measurement and aware of pushing care into outpatient settings.
“COVID has basically shifted the way in which sufferers are going to entry some modes of care and we predict we’re well-positioned for that,” Jacobson stated.
Whereas Carilion’s Agee stated her system additionally plans to spend money on extra outpatient amenities, she stated that’s balanced with the truth that the system nonetheless must receives a commission. Outpatient amenities obtain decrease reimbursement from insurers, however it doesn’t essentially value much less cash to offer companies at these websites in contrast with at a hospital, she stated.
“What we’re attempting to study as we’re migrating to ambulatory companies is carry out these companies much less expensively,” Agee stated.