Aligning Payers and Partners for Value-based Care
Aligning Payers and Partners for Value-based Care
AHA Knowledge Exchange
Hospitals and payers are compelled to align goals and expectations across the care continuum
As the health care field adopts value-based care models, hospitals, providers and payers are compelled to align goals and expectations across the care continuum to increase access to evidence-based, preventive and equitable care. Regulatory and market changes are impacting organizations’ value-based care strategies, calling attention to both challenges and opportunities. Data and analytics measure how initiatives influence consumer experience, patient satisfaction, quality and cost of care. This Knowledge Exchange e-book provides insights on how hospital and health system leaders are investing and partnering in this evolving landscape to create sustainable value for their communities.
8 steps hospital and health system leaders are taking toward value-based care
- Determine areas that could benefit from value-based models such as those with lower outcomes, higher costs, and unwarranted variation in process or supplies.
- Align on outcomes measures and benchmarks and carefully formulate and define accountability across systems and partners in value-based contracting.
- Build sufficient volume to support the necessary data analytics, organizational structure and case management function.
- Change workforce culture to support wellness and support care delivered effectively and efficiently outside the hospital.
- Identify clinical champions and incentivize physicians and other providers to improve outcomes and standardize clinical care.
- Engage patients in supporting their own health; work with other community leaders to support a healthier population.
- Strive to better meet the expectations of your patients and the entire community, learning from data and conversations how your hospital is viewed now, and what they wish could be better.
- Identify and use robust analytic strategies and risk-based stratification to understand the critical opportunities to improve community health.
Participants
Reg Blaber, M.D., MBA
Executive Vice President and Chief Clinical Officer
Virtua Health
David Burwell, M.D., MBA
Vice President of Medical Affairs and Chief Quality Officer
UPMC
Susan Bleasdale Casey, M.D., FACP, FIDSA
Vice President and Chief of Quality and Safety
University of Maryland Medical Center
John Chessare, M.D., MPH
President and CEO
GBMC HealthCare
Jimmy Chung, M.D., MBA, FACS, CPE
Chief Medical Officer
Advantus Health Partners
Bon Secours Mercy Health
Marty Fattig
CEO
Nemaha County Hospital
Raymond Hino
CEO
Southern Coos Hospital & Health Center
Cheng-Kai Kao, M.D.
Chief Medical Information Officer
UChicago Medicine
Carey Ketelsen, RHIA, CRC
Senior Vice President, Coding Solutions
CorroHealth
Doug Koekkoek, M.D., FACP, SFHM
Chief Physician and Clinical Executive
PeaceHealth
Stephen Merz, FACHE
Chief Operating Officer
Sheppard Pratt Solutions
Jerilyn Morrissey, M.D.
Chief Medical Officer
CorroHealth
Esther Muña, Ph.D., MHA, FACHE
CEO
Commonwealth Healthcare Corp.
Brian Nester, D.O., MBA
President and CEO
Lehigh Valley Health Network
Lesley Ogden, M.D., MBA
CEO
Samaritan North Lincoln and Pacific Communities Hospitals
Jim Wilson, MBA
Chief Financial Officer
Mayo Clinic Health System
Moderator:
Suzanna Hoppszallern
Senior Editor, Center for Health Innovation
American Hospital Association
AHA Knowledge Exchange
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