Video and Highlights for “5 Slides: Aligning Payment and Care to Drive Improved Health Outcomes”

On Thursday State of Reform hosted our Washington “5 Slides” event titled “Aligning Payment and Care to Drive Improved Health Outcomes.” This conversation was centered on how aligning care across physicians throughout the patient journey can have a direct and material impact on clinical and financial outcomes.

In this conversation, State of Reform host DJ Wilson was joined by Marc Rothman, chief medical officer at Signify Health, Dr. Judy Zerzan, chief medical officer at the Health Care Authority (HCA), and Max Holfert, program director for provider partnership innovations at Regence Blue Shield.

 

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Zerzan focused her comments on the HCA’s roadmap to value-based payments (VBP). In her remarks she said the HCA spends about $12 billion dollars on health care and because of that, they are committed to value-based care. She said they have had some success on the change to VBP.

“We put some of these goals into our contracts, to encourage adoption of VBP. And I think we have had some success with that especially initially.”

 

Image: Washington State Health Care Authority

 

Zerzan said they have since updated their goals to include health equity and whole person care as part of VBP arrangements.

“So not only thinking about physical health, but also behavioral health and how that might fit into this.”

Rothman talked about how to get provider groups onboard with VBP in his remarks. He said it’s important to provide real world examples to get “original detractors” of VBP to adopt the payment model.

“When we go out to networks of practitioners and try to get them to buy in to value-based purchasing arrangements through large organizations — either employers or state-based organizations like HCA — we’re really trying to show them that they can align and benefit by doing the right thing for patients and recouping some of that value for themselves.”

He used the example of spending for a diabetes patient.

 

Image: Signify Health

 

Rothman said:

“If you can reduce the exorbitant spend on unnecessary duplicative services, if you can reduce ER visits and reduce inpatient spend and a piece of the pharmacy through better adherence, those savings can be recouped in the practice.”

Holfert said the best way to drive change in health outcomes is to change the way care is delivered, and the best way to change care delivery is through bending the cost curve. 

“To drive real lasting change in the way we deliver health care towards that deeper value that we’ve talked about is by bending the cost curve while producing better outcomes and experiences for patients. But that is going to take alignment and it’s going to take commitment.”

 

Image: Regence Blue Shield

 

He said it will take a village to define what value in health care means to the health care system.

“All those stakeholders really need to come together to align on what it is that we mean by value, and to just be really, really crystal clear on that.”