Division among employers prolongs their inability to alter the healthcare system, but by acting together, value-based care will begin to spark change, said Lauren Vela, MBA, senior director, Member Value, Pacific Business Group on Health.
Division among employers prolongs the inability to alter the healthcare system, but by acting together, value-based care will begin to spark change, said Lauren Vela, MBA, senior director, Member Value, Pacific Business Group on Health.
Transcript
How can employers help move the healthcare system away from fee-for-service and to value-based care?
So, this is a really important goal, and we need to all do this. I think that there are many things they can do—the number one thing they can do is work together. Employers are fragmented, sort of, from a health plan’s perspective and the provider’s perspective—divide and conquer. We are divided and conquered, if not working together. So, we encourage our employers to ask for the same things from their health plans and their provider partners to have some core standardized measurement, some priorities in common. It’s really difficult for a provider organization to start practicing in a value-based way if only a small percentage of their patient population is paying for them to do that. So, I would say acting together is the number one thing they can do.
Are there particular payment reform models that employers favor?
Honestly, it depends on the employer. So, amongst our membership, we have some employers who are very invested in the Centers of Excellence program—that’s more of a bundled payment methodology—but we also have employers who are very invested in an ACO [accountable care organization] type of approach, which is more population health, shared savings, and sharing risk for total cost of care. So, I think that it really depends on the employer and their specific strategy. I would also say that we have some employers who invest in both of those strategies, because it depends on where they have headcount—so, in some geographies an ACO might make sense, but in some geographies it doesn’t based on their headcount and Centers of Excellence makes more sense.
I think it’s really important though, in talking about a bundled payment, that one thing that we’re always clear about is a very, very, very well-priced surgery, that wasn’t supposed to happen, is not a bargain.
Dr Dalia Rotstein: Physicians Must Be Aware MS Affects People of All Backgrounds
April 24th 2024Dalia Rotstein, MD, MPH, emphazises the importance of awareness that multiple sclerosis (MS) impacts patients from various backgrounds as clinicians think through ways to improve access to care and research efforts in MS.
Read More
Empowering Community Health Through Wellness and Faith
April 23rd 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In the third episode, Camille Clarke-Smith, EdD, MS, CHES, CPT, discusses approaching community health holistically through spiritual and community engagement.
Listen
Beyond Insulin: The Impact of Next-Generation Diabetes Technology
April 17th 2024Experts explain how new diabetes technologies like continuous glucose monitors are transforming care beyond intensive insulin therapy, offering personalized insights and improving outcomes for patients of all treatment levels.
Read More
Overcoming Employment Barriers for Lasting Social Impact: Freedom House 2.0 and Pathways to Work
April 16th 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. Welcome to our second episode, in which we learn all about Freedom House 2.0 and the Pathways to Work program.
Listen
Dr Michael Farwell on FDG PET/CT Imaging to Predict Immunotherapy Response in Advanced Melanoma
April 15th 2024Michael Farwell, MD, associate professor of radiology at the Hospital of the University of Pennsylvania, provides insights into a study on the benefits of using 18F-fluorodeoxyglucose (FDG) PET/CT imaging to detect metabolic tumor changes in skin cancer.
Read More