Commentary
PAYMENT ROUND OF 32 RESULTS: NOVEL APPROACHES MAKE IN-ROADS
The first round in the Payment Region is marked by a rash of easy wins, including a few upsets. One message received after this round is that innovative approaches in payments may finally be making headway in real cost control.
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Here’s how the four matchups in this region unfolded:
PAYMENT TRENDS
Evolution of Medicare Advantage Pummels Pursuit of Pre-Payment
As predicted, the number-one seed and arguably the tournament juggernaut, Evolution of Medicare Advantage easily picks off eight-seed Pursuit of Pre-Payment. One Committee member didn’t even expect pre-payment to show up. This blow-out was over before the half, 4-0.
“Marketplace incentives are driven by Medicare Advantage. Pre-payment is just following the money.”
Mark Cuban Effect Upsets Increase in Direct Contracting
This highly anticipated face-offwas a battle royale between two strong cost-cutting trends: Mark Cuban Effect (5) and Increase in Direct Contracting (4). Lots of enthusiasm for this game resulted in high-octane competition, with the final win going to Mark Cuban Effect (5) due to its consumer-driven nature and bipartisan political support. Furthermore, this trend is delivering a long-awaited industry reckoning for the pharmaceutical sector. In a consolation nod, the Selection Committee predicted that although it did not secure a spot in the Round of 16, we haven’t seen the last of Increase in Direct Contracting (4).
“The best matchup in the Round of 32”
Growing Primary Care Memberships Walks All Over Demise of the RVU
Early in this round, the Selection Committee agreed that the Demise of the RVU (6) was greatly exaggerated, and that even if the days of RVUs are numbered, they will hold on well in 2024. Memberships, however, are hot in many consumer sectors – retail, streaming services, news media – and there are plenty of reasons for patients to look at primary care through a membership lens. Patients might understand their benefits better in a membership model, and on the business side, it’s a legitimate attempt to create a sustainable economic model. In an easy 4-0 slam dunk, Growing Primary Care Memberships (3) takes the win.
“Memberships are hot, and RVUs are holding on for now.”
Economic Impact of SDoH and Health Equity Snags Win from Acceleration of Risk-Bearing Specialties
This matchup pits newcomer, Acceleration of Risk-Bearing Specialties (2), against tournament veteran Economic Impact of SDoH and Health Equity (7), which has appeared in various forms in every March Healthcare Classic. These trends lacked excitement among the Selection Committee, with both trends being described by one Committee Member as “stuck in slo-mo.” Whether from experience, aspirational fan support or just inertia, Economic Impact of SDoH and Health Equity pulls off a 3-1 upset.
“Some trends are trying to boil the ocean.”
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See the Round of 32 results in the other regions: Healthcare Landscape, Delivery, and Technology