Module 5
What Works and What Is Hard
The four structural obstacles no employer can solve alone, the strategies sorted by evidence strength, and an honest scorecard on the market that pays the most and has changed the least.
By the end of this module, you will be able to:
- Name the structural features that slow employer adoption regardless of intent
- Rank commercial strategies by the strength of the evidence supporting them
- State what recent legal changes did and did not fix
- The Structural Obstacles Four features of the employer market work against value-based care regardless of how committed any individual purchaser is. About 5 min
- Sorting Strategies by Evidence Sorting commercial value-based strategies by how well supported they actually are, from strong published evidence to marketing. About 5 min
- The Commercial Market: An Honest Scorecard The capstone: the commercial market pays the most, has moved the least, and now has the tools it always lacked. About 5 min
Module quiz
Answer all questions to see your score.
1. Why do the four structural obstacles matter more together than separately?
Any proposal for employer-led reform that addresses only one of these will underdeliver, which is a large part of why so many have.
2. What distinguishes the better-evidenced commercial strategies from the weaker ones?
Payment change that reaches clinical operations has produced measurable results. Payment change that stops at the transaction has produced smaller ones.
3. What should be concluded from transparency and fiduciary duty arriving together?
Information changes behavior only when someone has the capability and the incentive to act. The forecast should be held loosely and revisited against evidence.