Value-Based Care: What Happened, What’s Next

By Matthew Fusan, director of customer experience, SA Ignite.

Matthew Fusan
Matthew Fusan

Although the Quality Payment Program (QPP) has been in effect for a year, there continues to be a lot of change in the program as CMS continues to evolve. The new year creates an ideal time to reflect back on what changes we have experienced to date as well as look forward and examine what could happen in 2018 and beyond.

2017: A Year of Regulatory Confusion

As the QPP rolled out, confusion still reigned supreme at both the CMS and HHS levels:

2018: More Focus, More Models

While some programs are being cut/reduced, there is still pressure on CMS to accelerate new Advanced Alternative Payment Models (APMs) so they are exploring options during 2018.

While these models are all under consideration/in development, it will be interesting to see if the CMMI RFI will drive additional choice or will the changes proposed consume CMMI for 2018 and reduce the capacity to introduce new models. Either way, CMMI will look very different in 2018 and beyond.

2019: Change is Mandated

In 2019, critical components of MIPS are mandated, including:

Every Year: Organizational Change

The start of the QPP, even with the limited implementation of MIPS, has been a wake-up call to organizations. The tipping point occurs when organizations realize that success in value-based care programs requires continual organizational changes, including operational and clinical redesign, not just adding another set of tasks for employees and clinicians. No matter what year it is, sitting on the sidelines/doing nothing is no longer an option if you want to remain competitive. Organizations who strive to understand the changes, understand the impact to their organizations, and proactively improve starting now give themselves the best chance of success.

To stay up to date on value-based care best practices, changes to the Quality Payment Program, strategies to improve performance, and more, listen to the ABCs of the QPP webinar series to learn from a rotating cast of experts.

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