This episode of the MGMA Business Solutions podcast features Dr. Alex Ding, MD, MS, MBA, Associate Vice President of Physician Strategy and Medical Affairs at Humana. Dr. Ding discusses the progress and evolution of value-based care while sharing key findings from Humana’s 2023 Value-Based Care Report, which highlights the successes, challenges and strategies for implementing VBC arrangement.
His conversation with MGMA Sr. Editor Daniel Williams, MBA, MSEM, explores the impact of value-based care on healthcare quality, patient experience, and cost reduction, as well as the potential for further expansion and evolution of these models in various healthcare sectors.
Key Takeaways:
- Humana is working with practices directly to help them adopt value-based care, providing operational support and partnerships as well as implementing data and analytics infrastructure.
-Value-based care has shown significant progress over the past decade, leading to improvements in healthcare quality, patient experience and cost reduction.
-70% of Humana's Medicare Advantage members are now under VBC arrangements.
-VBC models promote a preventative and holistic approach to patient care, resulting in deeper engagement, stronger relationships with physicians, and more personalized care.
-Opportunities exist to expand value-based care arrangements to more providers and healthcare sectors, including specialty care and home health.
-Challenges to wider adoption of value-based care include the need to balance fee-for-service and value-based care incentives and the complexity of the transition process.
-Organizations like Humana can support the shift to value-based care through research, education, advocacy and direct partnerships with practices.
Quotes:
“Over the past 10 years, there's been a continual evolution and adoption of value-based care. In particular, we have a growing body of evidence that shows that value-based care is able to help us push for improvements in all of the components in the triple aim in health care that is quality, experience and cost.”
“I actually think the best way for us to expand value-based care at the center isn't necessarily to expand into more provider types or healthcare systems … What we really should be doing is expanding the payers and the payment models to open up opportunities to get those practices more members so that they can really build scale and accelerate moving their entire panel of patients, not just their Medicare Advantage subset of patients into value-based care practice.”
“I think it would be disingenuous to say that value-based care is the panacea to all of healthcare's problems. So why isn't everyone doing it right now? I think we need to recognize that such a fundamental shift in how we structure and work in healthcare means moving from a fee for service model that's been in existence for 100-plus years. This is a fundamental restructuring of healthcare from top to bottom – it takes time, it takes patience and it takes investment to make such a big change.”
Resources:
Coursera Course (with certification option) on VBC
MGMA Resources:
Connect With Us:
If you would like additional tools and resources related to medical practice leadership or you have stories to share with us, email us at Daniel Williams at dwilliams@mgma.com.
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