A New Administration, Value-Based Payment to Dictate 2021 Success

2021 may not have started as the fresh page everyone was hoping for, but a new administration could be making some well-worn strategies more relevant.

In a new Healthcare Strategies podcast, the editors of Xtelligent Healthcare Media shared their predictions and priorities for 2021. In the revenue cycle and healthcare finance space, some of those included the new regulatory landscape and value-based payment.

Listen to the full podcast to hear more details. And don’t forget to subscribe on iTunes, Spotify, or Google Podcasts.

HHS and the many agencies it oversees are currently experiencing a significant shake-up as newly-inaugurated President Joe Biden makes his picks for the next leaders of health policy in the US. This will certainly change the direction of federal healthcare, Medicare, and Medicaid policies in 2021 considering the stark differences between Biden’s and former President Trump’s healthcare agendas.

President Biden is quickly unveiling his healthcare plan for the next year, first addressing the ongoing COVID-19 pandemic. But Biden has also indicated that he plans to dive into Medicare and Medicaid eligibility, surprise billing, drug pricing, value-based care, and more during his tenure.

Much of the work will be handled via HHS and CMS regulation, meaning providers are in for a slew of policy changes in the coming year that are likely to significantly impact operations.

Policies that impact existing value-based payment models and new opportunities to shift away from fee-for-service are likely to be a common goal for the new administration and providers themselves.

Fee-for-service was not the ideal healthcare financing system during a public health crisis. When communities shut down, so did provider offices, causing revenue to dip by 50 percent or even more during the pandemic.

Providers in value-based contracts, however, were more prepared to handle the reduction in patient volumes and establish new, perhaps unconventional care pathways, such as telehealth.

Value-based contracts do not rely on the number of patients seen or services rendered, meaning providers had access to reimbursement even when volumes were low or when providers switched to virtual care strategies.

In order to build a more resilient organization moving forward, leaders will be more interested in value-based contracts and the flexibility they offer. The Biden administration is also just likely to be on board with developing new value-based payment models for providers to test.

Hear more about what revenue cycle and healthcare finance professionals will likely face in 2021, as well as other healthcare trends in 2021, including telehealth implementation and its regulatory challenges, vaccine development and distribution, payer landscape, care disparities and social determinants of health, and emerging cybersecurity risks.