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Steps to achieve a value-based contract

A shift to value-based payments and benefit designs is underway — accelerating, even– despite the significant obstacles, a health policy brief from the Brookings Institution has found.

The piece is co-authored by a heavyweight: Mark McClellan, M.D., Ph.D, senior fellow and director of the Health Care Innovation and Value Initiative at the Brookings Institution, former administrator of CMS, and former commissioner of the U.S. Food and Drug Administration.

The brief’s findings stem from literature reviews, a roundtable with stakeholders, and interviews with the roundtable attendees. It also cites statistics from the Catalyst for Payment Reform which estimates that 40% of payments are tied to quality or financial performance or intended to reduce waste. That’s a 29% increase from 2013.

The brief offers key steps to enable the shift to value-based contracts. Data will serve as the foundation for this effort — specifically, data related to the results and costs of care.

Here are three key steps to help achieve a value-based contract:

  • Build trust among payers, providers and purchasers. The authors of the brief believe that value-based payment models will compel meaningful partnerships and cooperation among parties, driven by their mutual goals of improved healthcare quality and lower costs. They suggest investing in long-term relationships among parties, identifying mutual goals, developing best practices, and cultivating a win/win mentality.
  • Identify opportunities for valued-based care via information sharing. Sharing meaningful information and data between payers, providers and purchasers is critical for managing patient populations and improving healthcare quality, the brief said. Furthermore, transparency encourages trust and collaboration. For example, parties could share data reports on a monthly basis. The authors also suggest that stakeholders have ongoing discussions of data needs and use of reports to make it easier to take action on the data.
  • Set standard core measures. “All stakeholders agree that standard core measures along with the supporting data infrastructure are helpful to accelerate the adoption of value-based payment models,” the brief said. “Not only do standard measures and supporting data minimize the administrative burden of implementing these programs, but it also provides a clearer signal for what is valued in the healthcare system.” A pointer the brief provides: Develop consistent, timely methods to promote data sharing across parties.