Our industry has spent fifteen years saying “value-based care.” Almost nothing changed. I’ve stopped believing that’s a failure of execution.
The failure is structural — the payment system itself. Our language just covers for it.
“Value-based” describes how a payment is calculated. “Earned” means you have to deserve it. If patient’s do better, you make more. If they don’t, you make less. That’s the whole difference.
Most of what gets called value-based in HME is fee-for-service underneath, with a quality bonus stapled on. Upside if you hit the metric. Nothing lost if you miss. A payment model with no downside isn’t a payment model. It’s a press release.
Meanwhile, CMS has told us in plain English where the ship is heading. Downside risk in every model. Prevention in every model. Waste reduced through payment design, not audits.
We can lobby against that current and every relief win buys one more audit cycle. Or we can take the wheel and steer with them. Small wins, delivered as collaborative partners, are how suppliers earn a voice in designing what comes next. That’s how everyone wins.
It’s why Eastern MedTech is pivoting to Earned Care. We earn our revenue when our patient’s do better. We earn less when they don’t. Guaranteed savings for payers from day one, with the rest of our revenue tied to verified outcomes. Two-sided risk, starting year one.
To my fellow operators, a question: if your revenue depended on your patient’s outcomes instead of your shipment volume, what’s the first thing about your company you would change?
Whatever your answer is, that’s the work. The early movers will own the next decade of this industry.
