ORLANDO—Providers and payers must continue to focus on efforts that transform healthcare delivery even as uncertainty persists around access to care and payment reform, prominent healthcare leaders said Tuesday.
Hospitals and insurers can't wait for federal policies to move the dial on value-based care and instead must pro-actively make investments to improve quality of care at lower costs, said Dr. Don Berwick, founder of the Institute for Healthcare Improvement, and Dr. Patrick Conway, president and CEO of Blue Cross and Blue Shield of North Carolina, in a panel at the IHI's National Forum on Quality Improvement in Health Care in Orlando.
"I don't think waiting (for policy changes) is a good option," Conway said. "I think there is a lot of innovation and change that can happen at the local level. We have a huge opportunity — we need to test and scale (new models) in a much more rapid fashion."
In the last year, efforts to repeal and replace the Affordable Care Act created much concern among providers about their patients' healthcare access. Providers are also still anxiously awaiting funding for the Children's Health Insurance Program. In addition, recent moves by the CMS to change payment models of care from mandatory to voluntary has caused uncertainty among some about where the agency stands on its move to value-based care.
"Uncertainty is destructive," Berwick said.
Given the ambiguity in future federal policy decisions, providers — and payers — have a critical role to play as change agents, said Dr. Raymond Vara, president and CEO of Hawaii Pacific Health who also spoke at the panel.
"We need to drive this change," Vara said. "If we are sitting back waiting for policy, we might be taken in a direction that is less informed."
The current system is unsustainable and doesn't benefit patients so it's in the best interest for organizations to change how they deliver care, Vara added. Hawaii Pacific Health has partnered with local community organizations to help underserved populations and address their social determinants of health.
"Payment or no payment" health systems are trying to tackle social determinants of health, Berwick said, adding he's "optimistic" that work will continue because it's the future of transforming healthcare delivery.
Conway agreed, adding that if payment reform focused on ways to improve the health of populations, "that is when you drive real change."
