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What We’re Watching: November, 13, 2018

THE DIVIDE

Premier CEO Susan DeVore gave her take on the healthcare implications of last week’s midterm election results on Cheddar TV. She explained that even with a divided government, the one thing our leaders will agree on is to zero in on healthcare costs.

What we’re saying: Repeal and replace is dead, at least for the next two years. But both parties will continue to view healthcare as the piggy bank to break for savings. The main spending pool being drug costs, which is a bipartisan issue but with big differences in how to handle it on both sides of Congress. And with Congress at loggerheads, the main event will shift to the agencies (i.e. Azar & HHS). We expect an aggressive agenda around lowering drug prices, creating more affordable insurance options, rapidly pushing providers to assume more risk in value-based alternative payment models (APMs), and HIT interoperability and access to information. Here’s more from Premier’s SVP of Public Affairs Blair Childs.

DON’T MAKE ME

HHS Secretary Azar revealed that CMS plans to launch two new mandatory episode payment models in addition to more voluntary risk-bearing APMs.

What we’re saying: The value-based payment train is moving fast, and the launch of more APMs is imminent. Think of value-based care like a treadmill speeding up. If you stand still, you’ll be thrown off. The only option for healthcare providers is to figure out how to keep pace. And keeping pace means taking on more risk. One need to look no further than the proposed MSSP ruling to fast track providers toward risk or the BPCI Advanced model, which requires providers to be at downside risk from the start. Hundreds of healthcare providers are already participating in these models with both public and commercial payers. Movement to risk is quickly becoming a requirement in order to survive in today’s healthcare environment. Premier members are outperforming others in APMs by sharing best practices and data, and leveraging insights from our years of work on these programs.

IN CASE YOU MISSED IT

What We’re Watching is a weekly blog focused on the current events Premier is following and their relevance to the work of Premier and its members.

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