Regardless of what Washington politicians do, value-based care payment models are the way to move forward in healthcare, according to Joseph Santos, think tank scholar at the Washington, D.C.-based American Enterprise Institute. Speaking at the October 3, 2017, Healthcare IT News Pop Health forum in Chicago, Santos said cost-sharing adjustments would likely drive behavioral changes that will result in better care at lower costs. With those goals in mind, he outlined his five principles of value:

1. Find a way to move from “simple-minded” fee-for-service (FFS). Although FFS will never completely go away, according to Santos, payment focus should be on “providing services toward more appropriate utilization. The goal is better health, not more healthcare.”
2. Integrate care delivery. Providers don’t practice in isolation and healthcare payment policies must reflect that reality.
3. Measure cost and outcomes for patients and make big data work. With the help of technology such as phone apps, providers can stay connected with patients through real-time connections with caregivers in crisis situations.
4. Make “doing the right thing” worth the effort of customers, providers and insurers. The industry has seen how it just doesn’t work to try to sell health insurance to young people with the marketing message that they cost the system less or because it will make them healthier in 20 years. People cannot act properly if they don’t know how to act. And this is also a challenge for physicians.”
5. Don’t lock us into mistakes already made. This principle is for policymakers. Antos cited two examples of mistakes: shifting authority from Congress to the executive branch and posting hard-to-understand healthcare prices for consumers.

Ultimately, Santos said, value-based care is here to stay and the real reform will not be significant changes in legislation.

“We’re not going to see any meaningful legislation in the next year, no big deals. There will be changes that generate some fixes, shifting the pea under the shells, but we’re not going to see anything big. Regulation is where it’s going to be at, not legislation.”

Antos previously spoke at length about the Affordable Care Act (ACA) on C-SPAN’s Washington Journal.