What do managed health care and ATMs have in common? They’re both based on systems designed 50 years ago. Even though ATMs are still around, they’re no longer the only game in town: Many people use their smartphone to access their bank account, or they use Apple Pay or Google Wallet instead of searching for an ATM to get cash. It’s been revolutionary change.
Health care, not so much.
Shouldn’t our health care system adapt to innovation? We say yes. The truth is that the system is stalled in the last century—and there’s a real risk it will stay there.
It’s time to bring health care up to speed. NCQA joined several health care organizations in a call for a new model of care. In a letter to Congress and the administration, we endorsed shifting from the fee-for-service health care system to value-based care.
We can make our health care system the highest quality, most cost-effective system in the world Value-based care is how it starts.
There are countless reasons why value-based purchasing works. And using innovative models to keep health care focused on the patient is the goal.
How can the system advance?
MACRA is a start. The bipartisan legislation is the most recent advancement. But there’s more to do.
Our letter made some recommendations:
- Empower and engage patients to make health care decisions with information and support from their care team.
- Engage patients to develop measures of provider performance.
- Recognize that the socioeconomic status of many patients creates challenges to improving care, and adjust payments to providers, as appropriate.
- Promote public and private investment in transparent, evidence-based testing and scaling of alternative payment models, as directed by MACRA, so clinicians, providers and payers can learn how payment models work and evolve in the clinical setting.
“Now is not the time for policymakers to signal a shift away from value-based care, either through action or inaction,” reads the letter.
Moving the bar higher on value-based purchasing will require buy-in from everyone in the health care sector. There’s already some consensus. The letter was signed by doctors and by specialty societies that represent physicians, health plans and payers. We expect more will join the cause as we progress.
That could mean long-awaited change. Revolutionary change.
Read the letter here.
Amy Maciejowski is a Program Manager for State Affairs at NCQA. She supports NCQA’s work with state legislators and regulators. Amy holds a master’s degree in Political Communications from American University.