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Dr Andrei Gonzales Discusses Industry's Progress Toward Value-Based Reimbursement

Payers and providers continue to make progress towards implementing value-based reimbursement, and while there is still work left to be done, experts are optimistic about a path to maturity, according to Andrei Gonzales, MD, McKesson's director of value-based reimbursement initiatives.


Payers and providers continue to make progress towards implementing value-based reimbursement, and while there is still work left to be done, experts are optimistic about a path to maturity, according to Andrei Gonzales, MD, McKesson's director of value-based reimbursement initiatives.

Transcript (slightly modified)

At the AHIP Institute, McKesson presented a study on how the healthcare industry is progressing toward value-based reimbursement. What were the key findings?

So the study is a review of payers and providers, with a focus on understanding how far along the industry is progressing towards value-based reimbursement. Some of the major themes that we’ve found in this study is we see that value-based reimbursement has really reached a tipping point in the industry, with payers reporting that they’re 58% of the way along the continuum towards value-based reimbursement, and providers reporting that they’re 50% along that continuum.

This is a comparative study, we did the same study 2 years ago in 2014 and what we found is there’s significant growth in their progression towards value-based reimbursement, with payers reporting that they’re 10% further along that path than they were 2 years ago and providers reporting that they’re 4% further along than they were 2 years ago.

So what we’ve seen is that the industry is really moving forward, but the payers are starting to outpace providers in their progression. We’ve found that all the value-based reimbursement models, they’re really all growing, but that bundled payments are reported or predicted to grow faster by both payers and providers, and that although bundled payments are predicted as one of the areas of growth, they’re also seen as one of the areas that are most difficult to scale.

So what we’ve found is that there are clear indications that the industry is moving, but there are also clear indications that this is going to be a struggle and there’s a lot of work left to be done. But one of the promising things is that 59% of payers see the industry reaching maturity in terms of value-based reimbursement in the next 5 years, and 55% of providers report the same, that they see the industry reaching maturity in that time frame. So there’s a lot of work left to be done, but a lot of the stakeholders in the industry really see a path to maturity for value-based reimbursement.

 
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