Reforms that support the expansion and adoption of value-based care should move us forward. While the changes highlighted in the article “Doctors and hospitals support value-based Stark law changes” are designed to do just that, the proposed regulatory reforms have potential unintended consequences that could hinder rather than help our healthcare system.
Creating considerable uncertainty, many of the proposed reforms fail to use the “bright line” test that we have been assured is the goal of Stark law regulations. There are also significant differences between the changes proposed by the Office of Inspector General and the CMS. The proposed changes will create additional administrative burden and increased costs that physicians must take into account. This is especially a concern for smaller physician groups or providers serving rural communities. I believe the CMS should consider creating a separate exception for rural providers with fewer requirements, as they often have a more difficult time transitioning to value-based care.
As a large national medical group committed to value-based care, my organization must have certainty that we are not running afoul of Stark law while entering into risk-based arrangements. Actions that are absolutely necessary to protect against waste and abuse should be the agency’s primary focus, and again, a provider’s time and financial commitment must be considered.
Finally, we understand the notion of limiting potential rewards to “non-monetary compensation,” however thoughtful alignment of incentives must be achieved, including financial, if these reforms are truly going to propel the industry toward coordinated and more affordable care.