Dr Charlie Fazio on Balancing Different Delivery and Payment Models

Charlie Fazio, MD, senior vice president and medical director of HealthPartners, discusses how to balance different payment models in order to understand their impacts on cost and patient outcomes when they are implemented.

There are a lot of different delivery and payment models being tested and implemented—how do you balance multiple at once and still understand the impact they are having on cost and outcomes?
As we are doing these payment trials we certainly worry about overlap and confounding the results as we try them. Fortunately, most of the things we are trying don’t have a lot of overlaps.

So, you think about bundles for orthopedic care—those are pretty well isolated and can be assessed one against the other, and in the ideal world we are looking at some patient outcomes, some patient satisfaction, and then the efficiency of the process. Those would be pretty well separated from an oncology bundle that we might be working on.

Then, an awful lot of the implementation trials we’re doing are in payments for primary care. Even if we look at population-based payments for those, and how those are working, and how patient satisfaction goes with those, the specialty bundles contribute to that but don’t necessarily confuse it.

So, we are carful to separate them, where it’s not always perfect, but they’re isolated enough that we can get a pretty good sense for how they’re working.
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