Lili Brillstein on Mandatory, Voluntary Payment Models

May 29, 2020

There will never be all mandatory payment models or all value-based models, but we can craft a value-based model around just about anything as long as everybody agrees on what the criteria is, said Lili Brillstein, CEO of Brillstein Collaborative Consulting, and former Director for Episodes of Care at Horizon Blue Cross Blue Shield of New Jersey.

There will never be all mandatory payment models or all value-based models, but we can craft a value-based model around just about anything as long as everybody agrees on what the criteria is, said Lili Brillstein, CEO of Brillstein Collaborative Consulting, and former Director for Episodes of Care at Horizon Blue Cross Blue Shield of New Jersey.

Transcript:

Do you think we will be seeing more mandatory payment models as opposed to voluntary models? Will we ever see exclusively mandatory payment models?

I think we will begin to see mandatory models. As I think about the evolution of the movement from fee-for-service to value-based care, from my perspective, it makes sense to start in a place where the providers have no risk and everybody has an opportunity to learn together how to create success in these models. They work best and everybody learns best, if the partners who are engaged in the models are those who have the propensity and the inclination and the willingness to change. Then, once the success is proven, to be able to share with other other partners who may come into the model, I think as that progression happens, and success is achieved, we'll begin to see more mandatorily required episodes in models. But I don't think that's going to happen immediately in any broad scale. As to the question around whether I think there will ever be all mandatory, I think absolutely not. I don't even think there will ever be all value-based care, I think there will remain some fee-for-service. I am a believer that we can craft a value-based model around just about anything, as long as you have a construct and everybody agrees on what the criteria is. But I think there will still always be some pieces of delivery that are going to be a fee-for-service.