Catalyzing the move to value based care in Florida

Florida health care leaders discussed the road ahead for value-based care systems at the 2021 Florida State of Reform Health Policy Conference. 

Different silos, from state hospitals to accountable care organizations to the insurance sector, came together to assess the move to value based care and the work still to come. 

 

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The panelists were Elizabeth Miller, CEO of Sunshine Health, Mary Mayhew, CEO of the Florida Hospital Association, Nicole Bradberry, CEO of the Florida Association of ACO’s, and Ray Parzik, senior director of value based contracts at Florida Blue.

Elizabeth Miller introduced the current state of value-based care approaches, saying there should be a standardization of models across providers. Even if those conversations are taking place between organizations at the executive level, she continued, they don’t always filter down to the providers themselves. Miller said:

“[Sunshine Health has] a value-based care program for maternal health, and I spoke with an OB/GYN…and while his office manager was well aware of the program, he really had never heard of it.”

Mayhew agreed with the need to standardize approaches to value-based care — specifically the roles of purchasers and providers in business model planning. However, for that to happen, agencies will need to rely on data measuring the model’s success, which is often out of date.

“Too often, we’re looking at two and three-year-old data, instead of quarter over quarter to drive that kind of, not only commitment in those risk-based arrangements but the ability to continually improve and to produce those outcomes.” 

Another way to move to value based care is by looking at long-term population health and incorporating social determinants of health in models. Bradberry says this framework can help reduce emergency room admissions and other potentially unnecessary costs. 

“A lot of the reason people don’t solve their health conditions long term is because there’s other things going on, the whole social determinants of health. And so, how do we prioritize? Everybody, when they’re in these models, they focus on that 12 month time horizon, and I think there’s going to be a lot missed if we can’t figure out the incentives and the drivers to help expand that.”

Looking ahead, Parzik says organizations should ensure their providers are aware of the trends and benchmarks of value-based care approaches so they can effectively take part in measuring the success of each model.

“Getting [providers] comfortable about talking about spending trends, annual trend markers…we have to get that sophistication raised. No knock on anyone, but it is complicated, and I think it doesn’t appear to get any less complicated.”

Other issues the panel addressed include ensuring smooth transitions for patients receiving treatment across different agencies and using the Covid-19 pandemic as a catalyst for value-based care. On one side, the pandemic caused many agencies to reevaluate the predictability and timeline of their delivery models. However, the pandemic also illustrated the success of telehealth and began conversations about how make it more accessible in the future.