Provider, Payer and OEM Collaboration Key to Value-Based Care Success

July 11  

Thank you to Navigant for contributing this report on our first Leading The Conversation of the year!

In practice, successful value-based care arrangements have proven to improve clinical outcomes for patients, and economics for all involved. Yet, the broader transition from fee-for-service to value-based models hasn’t been as successful or widespread as anticipated.

In order for the value-based care movement to be adopted successfully, healthcare providers, payers, and original equipment manufacturers (OEMs) must put aside the status quo, experts suggested during a recent panel hosted by Medical Alley Association and Navigant.

“The community as a whole has to be more openminded in working together and assuming good intentions – all around,” explained Tom Arnold, senior director of Health Plan Solutions for Medtronic, at the “Where Are the New and Improved Outcomes in Health” conference held in Minneapolis. “OEMs need to risk something, payers need to assume good intentions, and health systems need to trust their health plan.”

Blue Cross Blue Shield of Minnesota’s Interim Chief Medical Officer Mark Steffen, MD, and Navigant Managing Director Joe Galatowitsch joined Arnold on the stage to share real-world perspectives on how the healthcare community can accelerate the development and adoption of sustainable value-based care models.

To create a strong alliance, the involved parties must align on the agreement’s goals, how to improve care, how to validate and measure that improved value, and how to operationalize it effectively, the speakers agreed.

While payers and manufacturers can address some of these factors directly, healthcare community collaboration is key. For example, working together to standardize procedure management, care delivery, and reporting requirements, among other factors, across hospital systems would lift critical barriers to the successful design and implementation of value-based care programs.

“Overall, the environment is very open to new models for effective value-based arrangements,” Galatowitsch said. “But, with so many variables even just across different hospital systems, operationalizing and managing programs gets quickly messy and complicated.”

Beyond these elements, the speakers agreed evidence and performance data will continue to be key to secure and carry through successful value-based agreements.

“I might take a risk on a good idea, but there has to be a physiological connection that it will positively impact outcomes,” Steffen explained. “I need a powerful story, and I need to be sure members are out front. My first duty is to ensure there is no harm done to my members.”

Added Galatowitsch, who also serves on Medical Alley Association’s board: “Evidence, evidence, evidence. You can’t blindly jump into an agreement. We have to know what we’re getting into, and the agreement must be patient first. This includes understanding and clearly defining the patient population, outcome-related measures, and clear cause and effect.”

The conference held in June was part of the Medical Alley Association/Navigant “Leading the Conversation 2019” series, which brings together life sciences stakeholders and influencers. In part two of the series, “Does Price Transparency Matter?”, experts will focus on price transparency and its impact on healthcare outcomes on November 6 in Minneapolis.

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