Healthcare payment wargames

By | October 11, 2016

Drastically changing healthcare landscape turns payment wargames into reality

As a kid, I remember watching a movie about how a computer that was simulating a war game went hay wire and almost started World War III. When I attended business school, part of our initial class was a healthcare simulation game where we all represented a different part of the healthcare ecosystem and were given different scenarios that changed over the two days of the game. It was intriguing watching how different people thought when posed with different situations that they had to think about from someone else’s perspective. We had the ability to create partnerships, alliances, or go at it alone. What I remember the most was the impact of external factors, and the impact they had on how we thought and reacted.

I had the honor and pleasure to be invited recently to participate in a healthcare payment wargame that included a room full of the smartest people I could imagine representing many different organizations.  We were broken up into teams, and over a two-day period were presented with different “movements” that represented possible changes in healthcare payment reform over the next 10 years. Though we all did not reach consensus on every aspect, it did create a group think of where things might end up.

You can read the results of the exercise by downloading the meeting summary PDF.

I believe we are living in a real-time wargame every day. When I think about all the new models that have been designed and implemented by CMMI and CMS over the past few years, my head begins to spin trying to figure out what they mean and how they will impact the care and financials of our healthcare environment. I now spend a great deal of time thinking how to integrate all these new models and how to implement them in the most effective way to create value for those we serve. We have MACRA, CPC +, mandatory bundles, BPCI, all the innovation programs, MSSP 1-3, NextGen, transition care codes, chronic care management codes, Medicare Advantage, just to name a few. How we begin to think about all of these and how they will interact with each other is a wargame in itself. And to make this even more exciting, we have an upcoming election, that regardless of who wins, there will be additional changes and modifications.

Though I am all for change and innovation, I do wonder how all this will play out and what the unintended consequences will be. I give everyone and anyone that is presently in healthcare huge kudos for working and thinking in such times. It is very exciting since we are truly at an inflection point, but it is also exhausting to gameplay out so many different scenarios when the environment is quickly changing. What gives me great solace is that I truly believe we are doing this to take better care of people.