What’s Next?: The Future of Value-Based Care in the Digital Age

TL;DR

Industry leaders discuss the challenges and opportunities of value-based healthcare in the digital age, including payment barriers for emerging technologies and the effective use of data.

Transcript

so we've heard from a number of industry leaders today across a variety of topics that impact value-based healthcare from unique privacy considerations to healthcare fraud and abuse regulation to new types of health care transactions and we'd like to wrap up today's program by taking a look forward at what this is going to look like in the digital ... Read More

Key Insights

• 😨 Value-based healthcare is essential for aligning interests and promoting cost-effective care.
• 😀 Emerging technologies face barriers to payment related to their feasibility, adoption, and cost-effectiveness.
• 🛀 Telehealth reimbursement is evolving, with Medicare offering limited coverage and commercial payers showing more flexibility.
• 👶 Regulatory issues arise when new technologies trigger actions from patients or consumers, but the FDA is introducing measures to streamline the approval process.
• 😒 Effective use of data in value-based care requires alignment of interests, improved data access, and dispute resolution processes.
• 😌 The future of healthcare lies in genomic-based medicine and patient-centered outcomes research.
• 😷 California has mechanisms, such as independent medical reviews and mandated benefit requests, to accelerate the adoption of new technologies.

Questions & Answers

Q: How do emerging technologies create barriers to payment in healthcare?

Emerging technologies can face barriers to payment related to their technical feasibility, patient usage, and cost-effectiveness. These factors determine whether the technology is deemed fit for use and adopted by clinicians.

Q: Is telehealth reimbursable, and how is it evolving in the new payment structures?

Telehealth is an evolving area, with limited reimbursement from Medicare. However, there are new CPT codes and state Medicaid programs that offer reimbursement for telehealth services. Commercial payers also provide reimbursement for certain telehealth services.

Q: What are the regulatory issues involved in developing new healthcare technologies?

Regulatory issues can arise when new healthcare technologies trigger actions from patients or consumers. FDA approval may be required, and disputes over data ownership and accuracy can also pose challenges. However, the FDA has introduced a digital healthcare pre-certification pilot to streamline the approval process for software applications.

Q: How can the healthcare industry effectively use the data collected from mobile devices?

The industry should focus on the use of data in value-based care. Aligning interests in value-based reimbursement can help weed out technologies that are not cost-effective. However, there is a need for more discussion on how data should be used by both practitioners and consumers to improve outcomes and reduce costs.

Summary & Key Takeaways

• Industry leaders discuss the impact of value-based healthcare on various topics such as privacy considerations, healthcare fraud, and new healthcare transactions.

• The Trump administration estimates $435 billion in savings from healthcare deregulation over the next decade.

• The panel explores emerging technologies, barriers to payment, and the need for effective data usage in value-based care.