New CHI Report Finds Digital Health Technologies Must Play a Critical Role in Shifting American Healthcare Away from Fee-For-Service and Toward More Equitable and Effective Care
(WASHINGTON, DC) July 14, 2021- Today, the Connected Health Initiative’s (CHI) Value-Based Care Task Force released a new report on the critical role digital health technologies can play in advancing value-based care to make the American healthcare system more equitable and effective. Evidence clearly shows that digital health technologies helped expand access to healthcare during the COVID-19 pandemic and can address the massive toll chronic illnesses take on Americans and our healthcare system. But underutilization of digital health technologies is still present, and policy recommendations need to better enable connected health technologies to improve health outcomes and reduce costs.
Conventionally, payment of healthcare providers is based on the volume of services delivered to patients, which is called the fee-for-service (FFS) model. In contrast, newer value-based care arrangements typically include incentives to reduce overall patient spending while improving the quality of care, often using performance requirements designed to advance the quality of care.
CHI’s Value-Based Care Task Force (Task Force) report is based on a review of the healthcare ecosystem’s implementation of value-based care models to date, including in the context of Medicare. The Task Force found that despite Congress mandating a shift from the traditional fee-for-service approach to one that incents value and better outcomes in the Medicare and CHIP Reauthorization Act of 2015 (MACRA), that goal remains far from realized.
“The COVID-19 pandemic has only made the need for an improved approach to advancing value-based care more urgent,” said Morgan Reed, executive director of CHI. “The expanded use of digital health during the pandemic, while limited, demonstrated that these technologies can help make healthcare more efficacious and equitable. We urge Congress and CMS to take the overdue steps identified in this report to meaningfully shift from legacy fee-for-service approaches to a system that incents value and improved outcomes.”
The report highlights the examples of chronic illnesses and the role they play in both growing healthcare costs and widening disparities and inequities in the American healthcare system. Today, an estimated 133 million Americans – nearly half the population – suffer from at least one chronic illness, such as hypertension, heart disease, and arthritis, which is 15 million higher than just a decade ago and expected to reach 170 million by 2030. From a cost perspective, chronic illnesses account for 75 percent of the $2.2 trillion we spend on healthcare each year in the United States.
Based on the views and experiences of a diverse range of interests and voices from throughout the healthcare ecosystem, the Task Force identified key challenges to the responsible use of digital health technologies in advancing value-based care and developed corresponding recommendations to policymakers on how to overcome them. The recommendations from the report include:
Congress and the Centers for Medicare and Medicaid Services (CMS) should better enable providers to use digital health tools to enhance care quality while the transition to value-based care continues.
Congress and the U.S. Department of Health and Human Services (HHS) should enhance and accelerate CMS testing models that leverage digital health innovation tools and incent the use of digital health tools and support the responsible use of technology in APMs.
HHS should advance the appropriate two-way flow of health information to enhance value throughout the care continuum.
Congress and federal agencies should take coordinated steps to provide high-speed broadband to America’s underserved communities to support the use of digital health tools in advancing value-based care.
Congress should modernize privacy and security frameworks to support the use of digital health tools in value-based care scenarios widely.
The full report and its recommendations is here.