End of ACA Won’t Stop March Toward Value-Based Care, Experts Say
The arrival of a Trump administration will mean the end of the Affordable Care Act (ACA), likely through a budget reconciliation bill early in his term. But along with ACA elements that President-elect
That's what experts predicted during the discussion, "Oncology Care 2017," the final session of Patient-Centered Oncology Care, an annual multistakeholder gathering presented by
The panel featured experts in both oncology and in the ways of
Gottlieb predicted, as others have, that the
There might even be "relief" to fund risk mechanisms, Gottlieb said, which Feinberg noted
The key, Gottlieb said, is to address the broader problems within the insurance market so the country won't change course on healthcare every time the party in power changes in
While the panelists split on the merits of the ACA as it has functioned, they agreed that healthcare would keep moving away from fee-for-service toward value-based payment, though that is necessarily more complex in cancer care. "Everyone wants value," said Okon. "It's just a matter of how."
Feinberg framed the session around observations from keynote speaker
Because the time frames of government regulation can't keep pace with scientific advances, NCCN's guidelines can offer a foundation for value-based reimbursement in cancer care, for
For Patel, one key to a value-based healthcare system of the future is improved patient literacy. Even Gottlieb, an acknowledged critic of the ACA, said the HealthCare.gov website improved its consumer navigation tools between its debut and the current year.
Said Patel, "I still practice medicine, and I've never had more people asking me how to buy insurance."
On the first day of the meeting, Beveridge explained that before the ACA, health plans relied on underwriting, a practice in which actuaries determined that some people would not be covered because they presented too great a risk. The ACA ended this, Beveridge said, "which is a good thing. And I think the industry applauds that."
President-elect Trump has said he wants to continue this part of the ACA, known as guaranteed issue. To do so, Beveridge said that plans will have to work with providers on population health. "If you can't make the population healthier, then financially you're not going to do well," Beveridge said.
In the world of cancer care, there will be more attention paid to areas like palliative care, data sharing, transparency, and nurturing stronger relationships between physicians and patients. Ultimately, the move toward value-based care means removing the historic antagonism between payers and providers and getting the two to work together. "Help your payer figure out who the good folks are, and who the not-so-good folks are," Beveridge said.
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