After Leading the Conversation, Value-Based Care Doesn’t Seem So Far Away

July 2  

2018’s inaugural Leading the Conversation events brought together stakeholders to speak frankly about two topics: the challenges facing the mental health profession and how to practically define value-based care. The first Leading the Conversation of 2019 built on the foundation laid in those discussions and addressed the value-based care question from another angle: Where are the “new and improved” outcomes value-based care was supposed to bring to healthcare?

With an incredible lineup of decision-makers and senior executives set to speak, the event sold out as expected and 200 Medical Alley leaders arrived at The Depot ready to hear why value-based care is taking so long to arrive and how they could prepare their own organizations for the future.

Exactly why value-based care arrangements break down varies wildly but, as the afternoon drew on, a picture of what it took to make a functional one came into focus. By looking at the common elements in successful agreements instead of the myriad ways to fail, the path forward opened up.

The three critical action steps that emerged were:

  1. Find the right partner
  2. Measure the right things
  3. Prepare for internal changes

No matter which side of the problem speakers came from, they agreed that value-based care was still the direction healthcare is moving and that companies should be positioning themselves for the change before it is forced upon them by one of the truly massive healthcare entities like CMS. But because the change has been slow and there isn’t yet a playbook to follow, finding a partner with similar risk tolerance and expectations for time and outcomes can easily be the difference between an operationalized agreement that reaches the marketplace and a year’s worth of meetings that come to nothing.

Having found the right partners in one another, Medtronic and Blue Cross and Blue Shield of Minnesota gave participants a look at what can happen when a value-based contract comes to life. In one of the most transparent, behind-the-scenes explanations of a value-based agreement ever given publicly, Medtronic’s senior director of health plan solutions, Tom Arnold, and Blue Cross and Blue Shield’s interim chief medical officer, Mark Steffen, discussed what it took for the two giants to come to an agreement around type 1 diabetes care. Early returns, the two agreed, were very promising, but getting to this point required creative thinking and a willingness to move past traditional strategies on both sides.

In exquisite detail, attendees heard how the pact came together around a shared metric, one both parties knew they could measure effectively and that would produce the outcomes they both wanted. Once established, they resisted the urge to tie other measures in, knowing that a simple answer to the question “Is this deal working?” was going to be more beneficial for both teams than a convoluted set of stats that painted a fuller picture but took months to properly validate.

While much of the discussion focused the external – how to find the right partners, how to open the conversation with existing partners, etc. — multiple participants, including opening keynote speaker Dr. Abe Jacob, cautioned attendees that they must prepare for the requisite internal changes as well. Getting your team accustomed to new mentalities, new metrics, and sometimes even a new workflow is challenging, but a focused team with buy-in from all levels is a force to be reckoned with and can overcome the obstacles inherent in any new endeavor.

It would have been nice for attendees to walk away from the first Leading the Conversation event of the year with a step-by-step process for creating, executing, and expanding value-based healthcare in their own organizations. Any such guide would have been incredibly disingenuous, however; one simply does not exist. Instead, they took home a better understanding of what separates the agreements that take off and succeed from those that never leave the ground, a sense of what common definitions are most necessary in a value-based agreement, and what potential pitfalls must be addressed both internally and externally to get the buy-in necessary on both sides for an agreement to have a chance.

We’re thankful to everyone who joined us for coming to take on this challenging topic, to our sponsors — Navigant Consulting, Associated Benefit and Risk Consulting, West Monroe, and Ximedica for their support, and especially to our speakers for honestly sharing their experiences — good and bad — with the Medical Alley community. We hope to see you all at “Leading the Conversation: Does Price Transparency Matter?” in November!

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