Value based care (VBC) is being championed by many members of the pharmaceutical industry as a better way to provide care and services to patients. Matthew Hellinger, director in the business consulting services at Kaufman Rossin, and Ian Goldberger, principal of transaction advisory and transaction advisory lead at Kaufman Rossin, discuss the hurdles that payers are facing and why they’re still pushing forward with VBC.
Pharmaceutical Executive: What are some of the hurdles making the adoption of VBC difficult?
Matthew Hellinger and Ian Goldberger: Technology infrastructure and adequate data analysts to manage medical expenses and assess funding in relation to members’ risk scores and medical costs are challenges in the adoption of value-based care.
In addition, there can be a big learning curve for providers. Many providers may not be familiar with key terms that drive financial performance in VBC, such as MRA, IBNR, Rebates, etc.
It can be difficult to assess quality outcomes for specialists. Currently, most VBC models are currently in place for primary care, with only a few specialties such as nephrology having robust programs.