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SCAN CEO Sachin Jain: Healthcare should be thinking more about the pitfalls of value-based care


As the industry continues its march toward value-based care, it should do so with a critical eye, says Sachin Jain, M.D., CEO of SCAN Health Plan.

Jain told Fierce Healthcare that value-based care has become akin to religion, with the industry taking it on faith that these models will drive beneficial change. But there are potential pitfalls, and an open dialogue about them is necessary to make sure value-based models evolve to serve patients effectively.

“We’ve really had an uncritical dialogue about value-based care,” Jain said. “I’m just hoping we can simultaneously increase dialogue around some of the potential unintended consequences and how we guard against them.”

One of the central challenges of value-based care is managing costs and quality while ensuring patients have a positive experience, Jain wrote in a column for Forbes.

For example, value-based care organizations tend to prioritize palliative care or hospice for patients who have terminal illnesses. While this may be the best solution to reduce unnecessary services—and for patients’ comfort—a patient may feel they’re not being allowed to fight their illness.

Plus, value-based care models prioritize primary care over specialty care, and they may set up narrow networks to avoid pricey referrals. General practice physicians are empowered to […]

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