PAC value is quickly being redefined. The building blocks of the healthcare infrastructure are moving into the third and fourth trajectories of payment reform: alternative payment models based on fee-for-service structure, and population-based payments and capitation.
As the move toward capitation speeds-up, the importance of integrating the continuum, including post-acute care increases. The powerhouse driving value-based care is APMs (Alternative Payment Models). APMs align public and private stakeholders and are the critical mass for payors to adopt the same goals of moving forward towards value-based care.
- Medicare is the most prevalent sponsor of APMs.
- State Medicaid plans and commercial payors are expanding into a range of APMs.
- 50% of the largest commercial plans’ medical spend are in APMs.
APM trends are reinforced by the passage of MACRA which contains new incentives for physicians to join APMs. MACRA is the thread weaving its way to “un-solo” the healthcare delivery system.
In the May/June 2018 issue of The Remington Report, we point directly to the change in the infrastructure affecting PAC providers:
- The new focus on discharge planning, patient choice and post-acute providers.
- Telehealth usage advancing through policy changes.
- Bundled payments and the windy road for PAC participants.
- Medicaid and Medicaid managed care preparing for value-based models.
- The value-based market transformation taking bolder steps.
- Value-based innovation models changing the status quo.
Value-based models will continue to grow. For PAC providers it means more shared-risk contracting is in your future.