It’s time to lead by example on value-based care

Healthcare is constantly looking for new ways to tackle its perennial problem: How do we improve care and make people healthier? Almost always, it comes back to finance. Insurers have attempted narrow networks and even HMOs in the past. Patients though, continue to complain about the high cost of care or lack of access that comes with high-deductible health plans. CMS piloted reimbursement models that moved away from fee-for-service, but many of those models are voluntary.

In order to truly change the system, patients must work together with an integral part of their care team.

So how do you get physicians to buy into delivery experiments, treatments and actions that might affect their livelihood?

In a 2020 Deloitte survey of physicians, almost all participants said they were salaried. Just over a third said value-based care was a factor in part of their pay.

Some health systems are going more granular.

In this issue, policy reporter Michael Brady explores how some systems are bringing value-based pay to physician compensation (page 36). It could be a hard pill to swallow, but it could also harness type-A doctors’ competitive spirit in a new way.

In any organization, executives need to foster a culture that will promote their goals, and that could include taking on more risk themselves.

HCA Healthcare shareholders earlier this year tried to do exactly that. They pushed for a vote that would make care quality a bigger factor in executive incentive pay. The vote failed. A Health Affairs analysis last month couldn’t establish a connection between hospitals’ care quality and executive pay.

So ultimately, it’s up to you.

If leaders aren’t willing to stake their own value on value-based care, they will have little luck convincing their staffs to take the risk.