The Subcommittee on Health, chaired by Rep. Michael C. Burgess, M.D. (R-TX), held a hearing examining ways to meaningfully evaluate, and responsibly increase the use of value-based models and arrangements in the Medicare program. Members discussed how those initiatives currently operate, as well as how they could work in the future. Members heard about potential barriers to providers, companies and patients pursuing such arrangements, regulatory and statutory hurdles, and how adopting new technologies could play an important role.
Value-based care models have been largely effective and have gained support throughout the country as they have proven to improve quality of care and lower costs – boasting positive outcomes for patients, physicians, insurers, and the overall health care system,” said #SubHealth Chairman Burgess. “As we have heard from witnesses at other hearings on this topic, taking these models on as a physician or health care system can be a difficult, yet rewarding task. As a physician and as a Congressman, I believe it is important for physicians and health systems to take on risk when it can lead to rewarding outcomes, both for them and for their patients. Promoting innovation and quality are essential to modernizing American health care and enabling our world-class physicians to focus on providing coordinated, quality care to their patients.”
- Nishant Anand, Chief Medical Officer, Adventist Health System (Opening Statement)
- Mary Grealy, President, Healthcare Leadership Council (Opening Statement)
- Timothy Peck, CEO, Call9 (Opening Statement)
- Morgan Reed, President, The App Association (Opening Statement)
- Michael Robertson, Chief Medical Officer, Covenant Health Partners (Opening Statement)
- Michael Weinstein, President, Digestive Health Physicians Association (Opening Statement)
“As the growth in demand for healthcare services outstrips supply growth, tech-driven tools like artificial intelligence (AI) are maturing from shiny objects into meaningful enhancements to the practice of medicine,” said Mr. Reed. “In fact, experts are referring to AI in the healthcare context as ‘augmented intelligence,’ an accurate description of its current and predicted future roles in the medical profession. Stakeholders across the healthcare field recognize that connected care can be a multiplier of—rather than an impediment to—caregivers’ ability to treat patients. However, in many ways, the policies dictating the use of technology have detracted from the time caregivers spend with patients, particularly because of the arcane nature of Medicare regulations and payment policies. All is not lost. Other highly regulated industries have successfully overcome these obstacles and empowered innovators to drive convenience and cost-effectiveness.”
Dr. Anand highlighted current barriers that are impeding the general ability to redesign the delivery of care that are still locked in the past, treating all providers as if they are still being reimbursed for volume, not value. Those barriers included: The Stark Law, payment incentives in value-based models not being aligned with value, and operational challenges like interoperability and technology.
The Majority Memorandum, witness testimony, and an archived webcast are available online HERE.