A transition to a value-based Medicare system is now “urgent” for the Trump administration after new COVID-19 data revealed significant racial disparities among Black and Hispanic patients.
Providers could face much heavier pressure to deliver quality outcomes, while being prodded to work harder to eliminate treatment and results differences among patients of different races.
“When implemented effectively, [a value-based system] encourages clinicians to care for the whole person and address the social risk factors that are so critical for our beneficiaries’ quality of life,” Centers for Medicare & Medicaid Services Administrator Seema Verma said in a statement Monday.
Black Medicare beneficiaries were hospitalized with COVID-19 at rates nearly four times higher than white patients, while and Hispanic patients were about twice as likely to be hospitalized from Jan. 1 to May 16. The data showed more than 325,000 Medicare beneficiaries were diagnosed with COVID-19 in that span.
The findings come after several studies linked nursing homes with more Black residents with an increased chance of having COVID-19 cases.
“The disparities in the data reflect longstanding challenges facing minority communities and low-income older adults, many of whom face structural challenges to their health that go far beyond what is traditionally considered ‘medical,’” Verma said.
CMS argues that any solution to address the disparities would require a “multi-sectoral approach” from federal, state, local, community-based and private entities. Providers would be rewarded for keeping patients healthy through a value-based system, putting the focus on the health of a patient rather than the delivery of care, according to Verma.
“We have to hold providers accountable for the outcomes they achieve, and poor health outcomes for minorities or those of a lower socio-economic status is not acceptable,” she wrote in a blog.
“Until we move to a system that incentivizes value over volume and starts paying doctors for better health outcomes, we’ll never be able to adequately address the social determinants of health,” she added.
The data also showed that dual-eligible benefices (enrolled in both Medicaid and Medicare) had higher hospitalization and infection rates when compared to patients enrolled in just Medicare.
End-stage renal disease patients were found to have the highest hospitalization rate among all Medicare beneficiaries.