Payer Policy Changes Needed To Accelerate Shift To Value-Based Care, Whole Person Care

A slate of payer policy changes are needed to expand the use of value-based care (VBC) and whole person care. The policy changes address alternative payment models, the use of higher value sites of service, pharmacy services, and ways to eliminate wasteful administrative spending. In particular, Medicare coverage of newer home-based services, remote monitoring, and hospital-at-home should be expanded. Medicare Advantage policy should protect in-home care models. Medicaid home- and community-based services (HCBS) should leverage managed care capabilities.

The recommendations are intended for government entities and other payers. They were presented in a white . . .