Health Care Organizations to President Trump: Don’t Block Value-Based Care

Top hospitals, insurance providers, and pharma companies back patient-centered payment models

The National Coalition on Health Care (NCHC), a nonprofit group based in Washington, D.C., has sent a letter to President Donald Trump and Vice President Mike Pence asking them to back the continued movement toward value-based, patient-centered payment models that reward providers for improved quality and cost-effective care. The letter was signed by 120 top health-care organizations, including hospitals, biopharmaceutical companies, and insurance providers.

“Through private and public sector alignment, the move toward value-based care is succeeding, measurably improving health care quality and contributing to historically low costs,” the letter said. “Now is not the time for policymakers to signal a shift away from value-based care, either through action or inaction.”

Speaking on behalf of the organizations that signed the letter, the NCHC envisioned a “modernized, sustainable health care system” based on 10 principles:

  • Empower and engage patients to make health care decisions with information and support from their health care teams.
  • Invest in engaging patients in the development of measures of provider performance that are relevant to them and consistently and transparently reported by all public and private payers.
  • Improve clinician and provider access to timely, accurate, and complete claims data to better-facilitate care management.
  • Recognize that the socioeconomic status of many patients creates challenges in providing care, and adjust payments to providers as appropriate.
  • Design voluntary payment models that incent greater participation and achieve the highest quality and cost value based on patient choice and competitive markets.
  • Expand the use of waivers from fee-for-service legal and regulatory requirements that impede collaboration and shared accountability, while preserving consumer protections and safeguards against fraud.
  • Build on and expand payment models that promote collaborative financial and care coordination arrangements using incentives that align payers, health care providers, providers of long-term care services, and clinicians.
  • Appropriately incent access to medical innovations and treatments that hold the potential to improve quality of care and reduce overall system cost.
  • Promote public and private investment in the transparent, evidence-based testing and scaling of new alternative payment models as directed in MACRA [the Medicare Access and CHIP Reauthorization Act] so that clinicians, other health care providers and payers can learn how payment models work and evolve in the clinical setting.
  • Ensure alignment between private and public sector programs, which is critical to a sustainable value-based payment marketplace.

“Despite all that we’ve managed to do, health care is increasingly unaffordable––for families, for businesses, and for taxpayers,” John Rother, president and CEO of the NCHC, said in a statement. “Even in the relatively stable employer-sponsored insurance market, deductibles are climbing, and the average premium for a family plan has topped $18,000 a year. If we are to have any hope of taming these increases, we must accelerate, not slow down, the transition from volume to value.”

Sources: NCHC Letter; January 25, 2017; and FierceHealthcare; January 26, 2017.