Shifting to Value amid Pandemic and Staffing Challenges

The gradual shift to value-based care was slowed by the dual challenges of the COVID-19 pandemic and staffing shortages in healthcare, allowing traditional reimbursement models in primary care to remain as medical group leaders worked to overcome these new challenges. As recovery continues, value-based models — which base compensation on health outcomes and quality of care delivered — are poised to grow. 

Like most aspects of everyday life, the reality of medical groups’ approach to value-based care does not look the way it did prior to the pandemic. Beyond shifts in practice ownership and the several updates to practice facilities and safety measures to protect against COVID-19, the approaches to updating care delivery models has reflected the changes in staffing and further investments in digital health tools.

This report builds on a 2019 joint Humana-MGMA research study report that identified the necessary strategic changes to personnel (for care collaboration) and technological infrastructure (for quality data) for successfully shifting to a value-based care model in the primary care environment. New quantitative data from primary care groups that weathered the perfect storm of the pandemic and labor shortages is combined with direct insights from practice leaders on their journey toward value, the return on investment (ROI) thus far, and the changes required to sustain value-based initiatives in the face of unprecedented difficulties.

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