As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the first-ever Becker's Healthcare Payer Issues Virtual Summit, which will take place Aug. 3 from 12 p.m. to 2 p.m. CDT.
Rodrigo Cerdá, MD, vice president of clinical care transformation at Independence Blue Cross, will serve on the panel, "The effect of COVID-19 on value-based contracting and reimbursement for telemedicine." To learn more about the conference and Dr. Cerdá's session, click here.
Question: What's one telemedicine reimbursement trend payers should be watching right now?
Dr. Rodrigo Cerdá: Parity (pay the same as in person) vs. equity (pay in a way that reflects value and cost of provision). Whereas we may have to pay parity today while the pandemic is ongoing for a variety of reasons, we should be planning for an equity-based approach that acknowledges that the care and needs of telemedicine are different. Ideally we should incorporate non-fee-for-service approaches as well, including capitation and episode-based payments, to allow healthcare providers to determine the right combination of in-person and virtual care to meet patient needs.
Q: What's a notable way the coronavirus pandemic has affected value-based care contracts?
RC: Independence complements shared risk arrangements with most of our health system partners with pay-for-value programs in primary care and select acute and chronic episodes. Operationally, the three main components of these programs — cost of care, quality, and risk adjustment — are affected by COVID-19. People are seeking less care (both necessary and unnecessary), which means that per capita costs are generally lower in this area. The other side of that is that providers aren't able to do many of the things that we would use as markers for quality in a normal year — colonoscopies, DEXA scans, mammograms weren't happening at all for a while — and they're also not able to see patients and document disease states that help with risk adjustment. We are working with our value-based partners to adjust to this new reality and ensure we are continuing to support access to high-quality, affordable care.
Q: What attributes do the best leaders have?
RC: Now more than ever we have to be willing to listen and adjust to changing circumstances, balancing the needs of the immediate crisis with ensuring we plan for a better future coming out of it.