Video: How value driven systems of care are evolving in Alaska


Ethan Kispert


Sheldon Fisher, chief strategy officer with Providence Health and Services, Rhonda Prowell-Kitter, chief financial officer at Public Education Health Trust, and Dr. Rob Lada, a physician at Peak Neurology, discussed value driven systems of care at the 2021 Alaska State of Reform Health Policy Conference.


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The three presenters spoke about establishing a clinically-integrated network (CIN) in the state, silos in patient care, and the idea of early adopters. 

Fisher explained his idea of what a CIN means for health care providers and their patients. 

He uses a concept called the “quadruple aim.” According to Fisher, the aims are “the quality at the top, cost, the patient experience, and the provider’s experiences providing both an efficient and rewarding system to operate in.”

The new model should help address the siloed nature of health care in the state. 

“Alaska, historically, has been in the traditional category where care is siloed and patients are often left to themselves to navigate care without a lot of direction, oversight, management, or support from health care professionals. As we move towards a value based care model, there’s an emphasis on being able to provide support when helping patients understand how to navigate that care and then a focus on preventive care in a data rich environment.”

Lada offered a provider’s view on patient care. He pointed out these “silos” in medical treatment that impact patients’ quality of care. 

“A lot of the silos focus on the patient’s diagnoses and the procedures that bring in more revenue.”

He said this traditional model benefits the providers but negatively impacts the patient’s treatment.

“[Silos] create a tremendous amount of variability in care and treatment, which ends up costing the overall system more and leaves a lot of folks at the wayside who are not getting the care that they need.”

He promoted the idea of collaboration to help spur better patient outcomes and long-term health, but said the integration won’t be easy. 

“Some of the bigger challenges are bringing hospital systems and individuals that are, in some sense, competing against each other or have never collaborated together.”

Prowell-Kitter shifted the conversation to the idea of “early adopters” and their coordination with providers in the CIN model. 

According to Prowell-Kitter, these early adopters will help spur change in the health care setting by being the first to take on new innovations. 

She used the Public Education Health Trust as an example. The non-profit health insurance company was one of the first groups in the state to offer services such as telemedicine for their patients and medical tourism for patients seeking care from other parts of the world. 

“Several companies have now jumped on board and the state of Alaska is starting to adopt those ideas as well.”