Strategies for Succeeding in Value-Based Care

STRATEGIES FOR SUCCEEDING IN

VALUE-BASED CARE Using Physician Leadership, Innovation and Collaboration to Transition From Volume to Value-Based Care

HOW TO POSITION YOUR PRACTICE FOR SUCCESS

THE TIME TO ACT IS NOW Medicare’s stated goal is to have at least 90 percent of payments tied to quality and value by 2018. Healthcare insurers are demanding quality and value more than ever.

ACO/MSSP/Population Health have not yet delivered on the promise.

HFMA found that “the penetration of population-based value-based payment (VBP) models is not yet having an impact on curbing growth in total cost of care. ACO models have cost more than the savings they promised.”

The popular program, which has grown to 561 participants, actually resulted in increased spending $384 million vs. $1.7 million savings.1 1 What is Driving Total Cost of Care? An Analysis of Factors Influencing Total Cost of Care in U.S. Markets May 2018 hfma.org/tcoc Medicare Accountable Care Organizations Have Increased Federal Spending Contrary to Prediction they

90%

MEDICARE PAYMENTS TIED TO QUALITY AND VALUE BY 2018

561 ACO

PARTICIPANTS

Would Produce Net Savings Avalere.com/InsightsMarch 19, 2018

PROVIDERS CAN BE SKEPTICAL

COSTING

$384 MILLION

That’s understandable. Value-based care models are supposed to: •

Reduce hospital readmissions while increasing postdischarge visits to providers

•

Reduce total expenditures per assigned beneficiary

•

Reduce hospital admission rates for COPD, asthma,

SAVING

$1.7 MILLION

congestive heart failure, bacterial pneumonia and emergency department visits •

Improve local utilization of healthcare services

•

Improve revenue and savings

WHAT’S NOT WORKING?

MISSING SKILL SETS So what’s not working? Structure has been established and systems have been built, but not enough attention has been placed on nurturing the following skill sets: •

Data/Evidence-Based Decision Making

•

Physician Leadership Skills

•

Innovation

•

Design Thinking

•

Change Management - Helping providers through transition

•

Process Improvement

•

Practice Transformation

•

Board Development and Training

•

Effective Strategy Execution

•

Collaboration

•

Trust Building

•

Accountability

•

Stress and Burnout

Snapshots from a strategy workshop of a physician-led Clinically Integrated Network

REQUIRES

HEALTHCARE TRANSFORMATION

VOLUME TO VALUE-BASED CARE

CARE

TRANSFORMATION & INNOVATION

SHIFTING PARADIGMS APPLY DESIGN THINKING & INNOVATION TO REQUIRES

REDESIGN & TRANSFORM THE CARE MODEL PHYSICIAN

LEADERSHIP

& INNOVATION & COLLABORATION

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PHYSICIANS MUST BE ABLE TO:

USE ANALYTICS TO MANAGE POPULATION EFFICIENCY

THINK STRATEGICALLY

THRIVE ON CHANGE & CHAOS

MAXIMIZE EFFICIENCY

COST MANAGEMENT

LEAD PRACTICE TRANSFORMATION

INFLUENCE & ENGAGE OTHERS IN CHANGE

MARKETING

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HOW WE CAN HELP 1.

2.

STRATEGY DEVELOPMENT

PHYSICIAN LEADERSHIP/ INNOVATION SKILL BUILDING • Boot Camps • Coaching • Academies • Fellowships

PERFORMANCE/PRACTICE

3.

IMPROVEMENT/TRANSFORMATION & CONSULTING

4.

BOARD DEVELOPMENT & EDUCATION

5.

CHANGE MANAGEMENT

CUSTOM TRAINING

HOW DO YOU POSITION YOUR ORGANIZATION OR PRACTICE FOR SUCCESS? RISK ASSESSMENT | STRATEGIES FOR SUCCESS | ACTION PLANNING

PHYSICIANS NEED SKILL BUILDING INNOVATION DESIGN THINKING DATA/EVIDENCE-BASED DECISION MAKING MARKETING POPULATION HEALTH

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