While I certainly understand the skepticism regarding the overwhelming alphabet soup of healthcare innovations, I wouldn’t characterize most of those acronyms as failures. Medicare Advantage (MA) has grown around 7% a year and now makes up the majority of our senior care. HMOs constitute the majority of MA, and thus HMOs also continue to grow. Patients selecting MA are what drives the growth of both. We can disagree with the new programs, dislike or even hate the changing landscape, but we cannot ignore the growth of these programs, the public commitments of every major health plan and CMS towards VBC, nor what this growth conveys about patient preferences.
Your last point, “They’re setting us up to fail again” is the very fear we all have. And this is the reason it is imperative to have a seat at the table of change rather than waiting and hoping CMS, UHC, and Aetna abandon their goals. We have meetings with CMS and every major national health plan routinely so that we can understand their new programs, and be at the forefront of change in a way that helps podiatry flourish and meets the payer’s goals. As your friend found out, not everyone can be a winner in the new VBC world (otherwise healthcare costs just keep rising!), so it is important to start paying attention to who is successful, learning the new rules of the road, and aligning yourself with the right partner.
The healthcare world is changing, and if we don’t participate in that change because we don’t like it, we will be left behind playing a game that someone else created without our input.
Michael King, DPM, Nashville, TN
