BFMV partners Darcy Devine and Briana Gordon attended Nelson Mullins’ annual conference on value-based care in Fort Lauderdale on November 2, 2023. Hearing the speakers’ presentations through valuation professional’s ears offered an opportunity to think through the impact of value-based care (“VBC”) on healthcare valuation. Here are our top takeaways from the meeting:
VBC is coming, ready or not. Expect a phaseout of traditional Medicare and a continued push to VBC on the commercial side.
VBC savings largely come from the hospital side (i.e., lower admissions, less costly stays). So, hospitals appear slower to adopt. However, it behooves hospitals to figure out their VBC game plan.
Artificial Intelligence (“AI”) promises to be a game changer in VBC – helping payers crunch huge amounts of data and helping physicians make real-time decisions in the exam room. But there doesn’t seem to be 100% trust in AI technology just yet.
There’s a more flexible compliance framework under VBC – relaxation of fair market value (“FMV”) requirements when certain conditions are met, for example. However, arrangements must still be commercially reasonable, and not all arrangements will meet the criteria necessary to bypass the FMV requirement.
VBC requires vast amounts of data collection and aggregation. Look for the data generated under VBC to be used in various new ways and to help government agencies weed out fraud and abuse.
As of now, VBC is primary-care-centric. While surgery is well-suited for the VBC world – with measurable outcomes and cost sensitivity – current VBC models largely leave out surgeons. As for specialty care, experts don’t seem to have a clear picture of how to integrate VBC. Models that can incorporate surgeons and medical specialists will be game changers.