DW Franklin CEO Tim Gary Talks to HealthLeaders about Value-Based Payment Models

December 14, 2015
Recently, DW Franklin CEO Tim Gary talked to HealthLeaders for the article “Ghost of Capitation Past Haunts Providers in Shift to Value-Based Care.” The article discusses the healthcare industry’s historic shift from payment for services based on volume to payment based on value. With the shift, providers are bracing for a hit to economically disadvantaged communities.

Healthcare providers fear CMS and commercial payers will not risk-adjust value-based payment models broadly enough, including failure to account for the health-shattering impact of poverty, Tim told HealthLeaders. “CMS tends to take a meat-cleaver approach when they need a scalpel,” he said. “It’s very similar to what we saw in the 1980s, when we moved to capitated payment rates. Providers went into deals without understanding the cost of care and the contributing factors to outlier cases.”

Tim says that a value-based model can work, but “it absolutely has to be adjusted for local demographics. You cannot count on the patients to have the support infrastructure in place; you cannot count on patients to follow the course of care.”

To read the full article, please click here.
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