Dr Gail Wilensky on the Likelihood of Continuing Value-Based Reimbursement Demonstrations

Value-based care strategies will continue to progress no matter who occupies the White House, according to Gail Wilensky, PhD, of Project HOPE. HHS Secretary Tom Price has indicated his support for limited demonstrations, but Wilensky predicts he will continue to push against large-scale mandatory demonstrations.

Transcript (slightly modified)

Do you think the country’s trajectory over the past few years toward value-based care will continue under the new administration?

I think we are on value-based care as where we need to be going forward, no matter who is running the administrations. We’re not quite as advanced as we like to talk about it. Most of the people who are doing value-based care strategies still reimburse their physicians using fee-for-service, which is not particularly compatible with value-based care, so we’re talking a little better game than we’re actually doing, but I don’t see us moving backward from where we are. It’s a question of how fast, how aggressively we’ll move forward to being really serious about purchasing value-based care.

What impact do you think HHS Secretary Tom Price, MD, will have on new payment model pilots?

The question about whether Dr Price, Secretary Price now, will pull back from pilots has been raised a lot. I think what he is likely to move away from are the mandatory demonstrations, which had been raised at the end of the Obama administration, and which have an appeal in that they don’t have to contend with self-selection as an issue. But I’m not sure they’re as critical as they’re sometimes made out to be.

His point, and I have some sympathy with this, is that by having large-scale, mandatory demonstrations, you’re basically taking away the right of Congress to make changes in reimbursement, and that, more than potentially limited mandatory demonstrations or voluntary demonstrations, is what he was pushing against, as well as the other Republican members of the Congress.