Home Trending Health podcast Spotlight Trends: Value as the Differentiator

Spotlight Trends: Value as the Differentiator

10 June 2021

Six years after the Medicare Access and CHIP Reauthorization Act (MACRA 2015), Vynamic’s Mindy, Ryan, and Jen discuss where we are today in the transition from Fee-For-Service (FFS) reimbursement to Value-Based Care (VBC). The episode opens with an acknowledgment that VBC is at a crossroads – the transition has been bumpy, VBC models have been “consistently inconsistent” (2:10), and the misalignment of payer and provider compensation models continues to be an ongoing challenge (3:18). The conversation then moves to what is needed for this transition to VBC to be successful; it requires operational overhaul (5:10), robust analytics, appropriate engagement of providers, and health system transparency. Innovation takes time and transitioning to VBC requires a shift in cultural mindset and a detailed strategy for change and adoption (8:10). The episode then explores what VBC means for Life Sciences companies, as the industry starts to reckon with the development of more expensive products with higher intrinsic value (14:50), including curative one-time treatments and gene therapies. From a market access perspective, Life Sciences companies should be creative with contracting and how they approach payers and providers about the products they bring to the market (15:18). Ultimately, these stakeholders will need to reach a middle ground to make products accessible to the right patients (20:04). As an industry, we should strive for “the art of the possible” (21:33) and engage in cross-sector thinking to make VBC models successful.

Podcast Tags: healthcare, MACRA, fee-for-service, value-based care, reimbursement, innovation, Life Sciences, strategy, market access, value-based payment over time (VBPOT)

Source Links – Below, we’ve listed links to some of the facts and resources discussed on this show.

https://revcycleintelligence.com/features/entering-the-next-phase-of-value-based-care-payment-reform

https://www.fiercehealthcare.com/payer/new-cmmi-director-says-value-based-care-models-at-crossroads?mkt_tok=Mjk0LU1RRi0wNTYAAAF8k4XqnunZZyMo3p_xn3tEs3yH708uXgCNuApAFnJQHSR0EYcv1E2LCt6NlhnrwdH2JyVf-V_pxlSfU24GHKz3P3xDIZMa8jQIoLXYaPdibJyNaBh1Cc4&mrkid=152778267

https://www.fiercehealthcare.com/payer/verma-says-value-based-care-models-haven-t-made-good-return-investment

https://www.fiercehealthcare.com/payer/providers-call-for-another-chance-to-sign-up-for-direct-contracting-model?mkt_tok=Mjk0LU1RRi0wNTYAAAF8dKGQQGD5eCW9fP3QjJTt2D336_V8b5iB8tDE7JqOsFLKdsRpvjVAlrQMysKq4T7UamDcOD1mve6rocLCDDeRVC2cdYdiQ8iLjpaC6J0UFZyS_CaD5xk&mrkid=152778267

https://www.fiercehealthcare.com/practices/medical-groups-urge-cms-to-walk-back-aco-quality-overhaul-citing-potential-negative?mkt_tok=Mjk0LU1RRi0wNTYAAAF824GfFyUI8FL_gS064nifCYSR3Zuk0KLpuNBZaeS1tB3UYGjMu883L-Dr2vtKP2pn19XwOcAZW-KlyrW9Zq1P7IUionDrt-hi739yRxkSO6YfNeiaYl4&mrkid=152778267

https://revcycleintelligence.com/news/a-new-administration-value-based-payment-to-dictate-2021-success

https://www.fiercehealthcare.com/practices/industry-voices-3-questions-providers-need-to-prioritize-as-they-look-to-take-more-risk?mkt_tok=eyJpIjoiWW1JeFpESmlPRFEwWkRsaSIsInQiOiJ2dlcwTkRqUUVsUUpUVm94T2h3cTd5UzNYcWp0cUJwZHpKVWUxZUxZVXRFVTFWamx4Ykh1NDJXckptYVIxZitFQzBDM1VvcncrWGRsQ1JNUzdDK2lOTURPOVQ2RVAzQmNib0dsWDVIOUhhMmlqOEpGc01aUGd4dktrU1RXNmVnWHpqaGFSb3RBYWdBZ3hOWXMzZnpzWkE9PSJ9&mrkid=152778267

https://digitally.cognizant.com/value-based-care-in-life-sciences-whats-it-worth-to-you-third-of-a-multipart-series-codex5396/

https://www.zs.com/insights/new-era-value-based-contracts

https://www.bakertilly.com/insights/implications-of-value-based-care-for-the-life-sciences

For additional discussion, please contact us at TrendingHealth.com or share a voicemail at 1-888-VYNAMIC.

Mindy McGrath, Healthcare Industry Learning Lead

[email protected]

Ryan Hummel, Executive

[email protected]

Jen Burke, Healthcare Industry Strategist

[email protected]

About Vynamic

Vynamic, an Inizio Advisory company, is a leading management consulting partner to global health organizations across Life Sciences, Health Services, and Health Technology. Founded and headquartered in Philadelphia, Vynamic has offices in Boston, Durham NC, and London. Our purpose is simple: We believe there is a better way. We are passionate about shaping the future of health, and for more than 20 years we’ve helped clients transform by connecting strategy to action.

Through a structured, yet flexible delivery model, our accomplished leaders work as an extension of client teams, enabling growth, performance, and culture. Vynamic has been recognized by organizations like Great Place to Work and Business Culture Awards for being leaders and innovators in consulting, company culture, and health. Visit Vynamic.com to discover how we can help transform your
organization or your career.

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