Recently in Utah, the transition from a fee-for-service payment model to a value-based care (VBC) payment model has been focused on at the state level. This is evident in Governor Spencer Cox’s OneUtah Roadmap and his recent announcement of the creation of the Utah Sustainable Health Collaborative.
Castell Health, an owned subsidiary of Intermountain Healthcare, was created with the mission to successfully advocate for the implementation of VBC models. The Utah-based health platform recently published six strategies for pivoting to VBC. These strategies include primary care visits are paid, how teams are structured, and education on the effectiveness of VBC.
The publication says, “getting value-based care right requires significant investment, commitment, and flexibility across organizations.”
Stay one step ahead. Join our email list for the latest news.Subscribe
The first of the six strategies is to align provider panels—the number of patients a provider sees—with at-risk patients. Next is to restructure teams and workflows, which it says is necessary to close gaps in access to care and coordinate more effective patient outreach.
Next, Castell highlights the need to educate providers and teams on the core tenets of VBC to “ensure that everyone is equipped to participate in this team’s effort.”
Data plays an important role in the implementation of VBC as well, according to Castell. One of the strategies includes the deployment of novel technologies to integrate multiple sets of data and overlay it with algorithms to use the data most effectively.
With these novel technologies, Castell plans to embed real-time insights from the data that can be incorporated into action in the daily workflow of care teams.
The last of the six strategies is to align financial incentives for payers, providers, and patients. Dave Henriksen, vice president of clinical operations and author of the publication, says,
“Until you can align the incentives for the payer, the provider, and the patients, I don’t think you can [implement VBC]. You can educate teams and redesign workflows, but all of that is contingent upon changing the way that people are paid. Once those incentives are aligned, now you want to operationalize these other five strategies.”
Henriksen says to make VBC happen, health care systems need to change the way providers and payers are financed and needs to create an aggregate health plan portal for providers. He says this value proposition will not only lower costs and improve quality, but make it easier for providers to give more time and adequate care to their patients.
“They will only have to use one platform, one set of tools, one program, and one person to work with. So, part of what we want to do is align as many payers—who want to deliver high quality care at an affordable cost—and help them get the attention they want of their members by grouping more members into a provider’s VBC workflow.”
Henrikson says Castell will continue to provide VBC contracts in 2022 and continue to work to implement VBC payment models around the state. However, that is already complicated without a pandemic in the mix as well.
He says Castell is going to focus mainly on technological innovation in this space.
“In 2022, we are going all in with digital technology and some at-home tools and resources to be able to help manage chronic conditions and diseases. We hope this will help us reach more of the population than we can currently reach today.”