Wellcentive, an Atlanta-based provider of value-based care solutions has launched a free tool to calculate the real cost of delaying the shift from public and private payer volume to value-based care (VBC) and reimbursement. The tool called the Cost of Inaction calculator helps organizations estimate the impact, based on national benchmark data for health services and the organization-specific data users submit, of delaying effective implementation and management of VBC practices.
Why Now Is The Time for Value-based Care
Private payers have historically followed Medicare’s lead regarding new payment models, and The Centers for Medicare & Medicaid Services (CMS) continues to roll out VBC initiatives with significant incentives. There is not just an opportunity cost for those who delay, however – payers are also imposing penalties and driving providers toward more financial risk.
As an example, a physician group with $200 million in revenue, 350 providers, and a payer mix of 30 percent Medicare and 30 percent commercial will experience a cost of inaction, using a conservative analysis, of $20 million over five years.
Value-based care is rapidly becoming both a catalyst for change and the industry standard driven by:
– The Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) proposed rule has been issued, which emphasizes advanced payment models, expanded quality and registry reporting and population health management.
– Bundled payment programs – also included as MACRA APMs – are expanding among payers.
– CMS recently announced the Comprehensive Primary Care Plus (CPC+) payment model – a MACRA Advanced APM – the agency’s largest multi-payer initiative for value-based primary care. The CPC+ model is schedule to begin implementation in 2017 across up to 20 regions targeting 20,000 physicians and approximately 25 million patients.
