April 2021

COVID-19 has been the greatest global public health challenge in the last century, and has been hugely impactful domestically, with more than 550,000 reported deaths, representing the third leading cause of death in 2020. The impact of this crisis across the value landscape has been nuanced. In some cases, COVID-19 has accelerated the pace of innovation, driving uptake of home dialysis and telemedicine. In other cases, it has disrupted core healthcare processes such as cancer diagnosis and preventive care.

Medicare’s value-based programs have taken every conceivable approach to managing these impacts. Some have paused operations, some have continued un-abated, some have excluded patients with a COVID-19 diagnosis, and some have reduced program penalties. In making these decisions, administrators have balanced the administrative burden of measurement, the goals of value-based care, and the impact of COVID-19 on the whole healthcare system.

While value-based programs have rightly taken a backseat to a global pandemic, Medicare is stepping on the gas to drive adoption of value-based care in the long term. This continued commitment is perhaps a reflection that the core components of value-based care, such as development of data infrastructure, identification of evidence-based best practices, intersectoral collaboration and implementation science to drive quality improvement, are key parts of the pandemic response as well.