URAC Report Finds ‘Value Movement is Non-Partisan,’ Will Continue Across Healthcare Spectrum

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Washington, DC -- In a series of articles with nationally recognized health industry leaders, URAC finds that value-based, coordinated care will continue to be the goal for physicians, pharmacists, case managers and others. URAC, the independent leader in promoting healthcare quality through accreditation, education and measurement, compiled comments from industry leaders over several weeks. The articles appear on the URAC blog.


“We may have a different administration, but the value movement is non-partisan and will continue apace,” said Don Crane, President and CEO, CAPG, an association representing physician organizations practicing capitated, coordinated care. “Changes will likely be around the margins, and underneath will be continued pursuit of care that’s delivered at lower cost at equal or better quality. We have to move from fragmented care to coordinated care. To physicians out there, our message is stay the course.”

For Michael Hunt, M.D., CMO/CMIO, St. Vincent’s Health Partners in Bridgeport, Connecticut, there’s a need for healthcare providers to accurately define what the cost of healthcare is.

“When you come down to actually providing healthcare and the choices the consumer makes and the demands within the system, there’s a cost to it,” said Dr. Hunt. “We’ve not really had a very good national conversation on the value of healthcare and what it costs to deliver it.”

Hunt added that his colleagues at St. Vincent’s are now looking at what an organized delivery system is, one that goes beyond a hospital system.

“What we’re trying to focus on in the next couple of years is, what does an organized delivery system look like, and how do you create that model so that all of the members find success under that umbrella?” said Hunt.

For pharmacists, particularly those working in specialty pharmacies, many of the challenges faced by doctors are percolating into the area of medication adherence.

“Countless studies have demonstrated that adherence is a critical driver to not only improve patient treatment outcomes, but also avoid unnecessary medical costs,” said Rashmi Grover, Pharm D., Director, Specialty Manufacturer Services, CVS Specialty™. “Driving medication adherence has been a constant challenge, whether the medication is Specialty or traditional and different programs have been continuously developed to assist patients with improved adherence.”

Grover added that the recent Medicare Advantage Value-Based Insurance Design Model currently being piloted in several states offers reduced cost sharing for enrollees who participate in disease management programs. 

“This is another testament to the commitment and value of improving patient medication adherence,” said Grover.

Leaders at URAC believe all of healthcare should be focused on improving and demonstrating value.

“URAC’s been a facilitator of quality across the healthcare spectrum for more than 25 years,” said Kylanne Green, URAC’s President and CEO. “Over that time, the landscape has changed. The conversation of value over volume isn’t new. In fact, there are healthcare organizations throughout the U.S. with decades of success, where value-based payments are the only form of reimbursement they know.  But now the momentum has shifted. This will impact all of us in healthcare. URAC is proud to be a pioneer in quality improvement as an independent accreditor of emerging healthcare models such as clinical integration, as well as cutting edge solutions like telehealth.”

To view additional insights from health industry leaders, visit http://blog.urac.org/topic/trends.

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About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC offers a wide range of quality benchmarking programs that reflect the latest changes in healthcare and provide a symbol of excellence for organizations to showcase their validated commitment to quality and accountability. URAC’s evidence-based measures and standards are developed through inclusive engagement with a broad range of stakeholders committed to improving the quality of healthcare.