Value-based care holds great promise for the future of healthcare. But getting there from today’s still-dominant fee-for-service model is a journey that demands bold decisions.
During a Becker's Healthcare webinar sponsored by Signify Health and moderated by Manjula Julka, MD, MBA, senior population health officer and vice president of medical affairs at Signify Health, Grace Hines, corporate vice president of system integration at Sentara Healthcare and President of Sentara Quality Care Network and Sentara Accountable Care Organization, shared lessons from Sentara’s journey to value-based care that may be informative for other organizations.
Five lessons from Sentara’s experience:
- Prioritize organizational alignment and accountability for quality patient care For Sentara, this meant developing a clinically integrated network (CIN) in communities where Sentara operates (Virginia and North Carolina). Ms. Hines’ team helped foster alignment by developing and articulating a shared purpose that both the health system and physicians agreed on: quality measurement and improvement. A tool to aid accountability has been creation of a population health database for the entire network, which involved pulling together data from diverse systems.
- Extend accountability into the post-acute environment. After quality was elevated as a priority, the next step was focusing on managing care in the post-acute space. That led Sentara to join CMS’ Bundled Payment Program Initiative (BPCI), which aligned incentives across providers to deliver high-quality care. “We were able to learn how to manage patients in the post-acute environment and our return on that investment has been very favorable, both clinically and financially,” Ms. Hines said.
- Focus on total cost of care. Taking its commitment to integrated care up a notch, Sentara entered the Medicare Shared Savings Program (MSSP). This involved managing a population of 64,000 beneficiaries while sharing financial and medical responsibilities for their health outcomes. “We took all of the learnings we had from the CIN and the BPCI program and all the systems and data we had put in place and applied them so we could manage this new population,” Ms. Hines said.
- Maintain physician engagement and partner with a health plan. To keep physicians invested in value-based care agreements, it is important to share successes in terms of health outcomes or financial savings achieved. “Any success we can demonstrate, however small, breeds confidence in what we're doing and why we're doing it,” Ms. Hines said. She said it is equally important to provide visibility into the data used for risk adjustments; create opportunities for socializing and cross-learning between primary care physicians and specialists; and provide CME credits and pathways for maintenance of certification. Ms. Hines also highlighted the value of partnering with a health plan — an arrangement that allows health systems to understand the payer’s perspective while enabling payers to offer a comprehensive network as part of their value proposition.
- Partner with external resources to ease the journey. Healthcare organizations do not have to know it all or do it all as they embark on their value-based care journey. This is especially relevant for care transitions, which are one of the trickiest parts of the patient journey, where many patients fall off the radar of physicians. Sentara teamed with Signify Health, whose Transition to Home solution complements care coordination programs. “With Signify, we gained the resources to help us with care transition management from the hospitals to the post-acute care setting, because that was a void we had,” Ms. Hines said.
Whatever path to value-based care healthcare organizations choose, working methodically and sequentially is a guiding principle that can make even the steepest ride a little easier.
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