Partnerships and Value

Attendee Feedback: How to Develop Value-Based Partnerships

October 5, 2017 12:22 pm

In breakout discussion groups, attendees were asked to offer input on key issues to address when developing value-based partnerships.

Here are four vital questions and the respective attendee answers.

What do health plans, hospitals, physicians, and employers collectively need to do to form a successful value-based relationship?

  • Understand the goals and vision of each entity at the start of discussions.
  • Learn about the culture of each organization when coming together. No one organization can have authority over other entities in the relationship; the relationship must be collaborative.
  • Establish common goals for care coordination and efficiency of care to achieve quality.
  • Establish trust and transparency with all stakeholders.
  • Share common data.
  • Remain open-minded, but agree to disagree.
  • Redefine roles up front; traditional roles should shift. Communicate often and effectively. Dedicated resources will be needed to ensure that communications between stakeholders are timely.
  • Offer education for all parties to help structure the new culture of collaboration. Define the infrastructure and dedicated resources from both a provider and a health plan perspective. A medical group and chief medical officer should be part of conversation.
  • Plan and structure the relationship using shared accountability.

What obstacles could potentially impede success?

  • Built-in silos within organizations
  • Inconsistent communication
  • Governance limitations or technical challenges in sharing information
  • Poorly defined strategy or plan design (resulting in a lack of focus on the patient)
  • Lack of technology (or an inability to utilize it effectively)
  • Lack of engagement among partners (are the right people at the table?)
  • Ineffective care management
  • Financial challenges (given that “the pie is not getting any bigger” and getting additional cost out of the system may be a formidable challenge)
  • Potential risks to previous capital investments
  • Regulatory, regional, state, and national uncertainty related to the impact of the Affordable Care Act, the Medicare Access and CHIP Reauthorization Act (MACRA), etc.
  • Cultural issues in implementing changes to move to value
  • Cost pressures, particularly for small community hospitals
  • Clinical variation
  • Narrow-network characteristics that may create access issues and perception problems for employers

What characteristics or capabilities are necessary for success?

  • Data: integrity, timeliness, ability to interpret and use
  • Acceptance of data
  • Transparency. Early wins to build trust and momentum
  • Champions/leaders to drive the effort
  • A patient-centered approach by all stakeholders

What are the limiting factors that each partner must overcome within its organization to build  success in a value-based partnership? 

  • Fear of change among organizations and people
  • Difficulty with the sharing and integration of data
  • Not having a defined set of quality metrics
  • Lack of access to an adequate volume of live data as opposed to claims data
  • A short-term focus as opposed to a long-term strategic perspective
  • Limited workforce supply (are there enough physicians?)

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