Dr Lee Norman on What to Consider in Value-Based Care Implementation

Lee A. Norman, MD, MHS, MBA, appeared at The American Journal of Managed Care^®’s Institute for Value-Based Medicine^® event on population health March 9, 2023, in Kansas City, Missouri, where he discussed the shift to value-based care. He served as the secretary of the Kansas Department of Health and Environment from 2019 to 2021 under Governor Laura Kelly. Norman, who served in the US Air Force and later as a colonel in the Kansas Army National Guard, is currently senior medical director for Optum Care Kansas City.

Transcript

What are some of the key considerations that health care providers need to keep in mind when transitioning to value-based care, and how can they ensure successful implementation?

Yeah, that's a great question. I think a number of things come to mind. One is that the fundamentals of good care have really not changed in a value-based care world. One, as we discussed last week, that evidence-based medical decision-making is critical. And it may sound obvious, but really, there's not a lot of evidence in some areas that we rely on clinical judgment, but where there is evidence for one pathway vs another one: really critical.

The second thing is very fundamental—shared decision-making. The day is here when we have honest and forthright discussions with patients: “This is a likely path that will get you there, this is one that's less likely and more invasive and could actually harm you.” So shared decision-making.

And then finally, I think it's really critical that in fee for service, which is where we've traditionally been practicing for years and years, it's not a matter of all of a sudden one day making a monumental shift to value-based care, where, among other things, there's compensation to the practice for having better outcomes, there's incentives being paid towards members of the health plans or patients—it's a hybrid model. And I think that physicians and other caregivers just need to get comfortable with the idea, it's not going to be a thunderclap where all of a sudden, at the stroke of midnight someday, that it goes from fee for service all the way over to value-based care. We have one foot in the boat and one foot on the dock, and we're having to kind of balance and get accustomed to value-based care.