A powerful panel discussion to emphasize on the impact of right tools and technologies to drive value based care for ACOs success we have briefly summarized the main points of the discussion.
John. P Schmidt: What are the key drivers for advancing value based care in ACOs?
Dr. Mansoor Khan: I would like to break this question into two parts, i.e.:
- What is driving Value based care?
- What is driving adoption of value based care?
So what driving value based care, is a macro-economic aspect. So if you have a look on how much we have spent as a country on healthcare and what our outcomes are, they don’t match up. Countries that are spending far less than us on per capita have better outcomes. So, it’s an unsustainable curve, and we need to bend that curve somehow. And I think that value based care is the best tool that will help us in bending that curve. So as per my point of view of why do we want to do value based care and healthcare cost is the primary driver.
On the other side, the adoption of Value based care is a whole different issue.
What I have seen and heard from the thousands of physicians that we serve, is that COVID has really pushed the needle. Folks that were doing fee for services got killed over the last few months due to the lack of visits. Telemedicine has started to change that a little bit but it still doesn’t fill in.
Those folks who had a big percentage of capitated population, they did quite well. Because they are not paying for a lot of services and yet they are still getting the income from the capitated payments. So I think when you think in terms of adoption, the biggest drivers for value based care that I see in a short term, is what folks have learnt in this COVID crisis where they have come to realize that if you sort of view this as a long term relationship with a patient, you work for their health and you get paid for maintaining their health then you are going to be much better off as a provider, and as a patient in the system.
John. P Schmidt: What moves the needle with respect to ACOs making investments decisions to improve their organizations’ value based care performance?
Dr. Mansoor Khan: When we look at large customers, they are a part of an ACO, they have Medicare Advantage lives, they are in bundled payments, they have commercial risk arrangements, and they have Medicaid risks, so they have a very complex environment they work in. And the physicians associated with such organization don’t know that the next patient who walks in the door what program they are going to be associated with and what are the parameters they have to account for from the value based care point of view for that patient?
And one of the biggest challenges, in any value based care program especially for ACOs, which have a lot of small practices specifically, is how to make that physician much more effective as they have too much to deal with – revenue pressure, cost pressures, patient quality pressure and a lot of other things happening in those small practices.
I believe there are 2 things that really move the needle.
One is the integrated approach that helps the physician to figure out what they really need to do at the point of care. It’s all integration, integration, integration. You make sure that all the tools you have are integrated and are available to the physician for the absolute minimum number of clicks.
Second area where we have seen a lot of success for small practices, is putting together some sort of a central organization, that provides, care management, care navigation, care coordination sorts of efforts. So it’s not a big investment, it can be few folks, relatively low cost folks – nurses, care managers at a central location with a right tool. This, I believe, has a great impact on the ability to move the needle as far as returns on the value based care are concerned.
John. P Schmidt: Given Telehealth, remote visits, remote patient monitoring have accelerated during the Covid-19 pandemic, are there any other new developments that could help advanced value-based care?
Dr. Mansoor Khan: As the world has changed we never thought that telemedicine or virtual care would accelerate at the speed that it has. So that I think is driving a change sort of under the radar right now but it may have a big impact down the line.
When I look at how Teledoc and Livongo are combining their capabilities, and wonder if these entities start to take on capitated risk with their ability to bring in physicians from anywhere in the country basically in an Uber model into medicine, there is a significant danger to the small practices as they can become dis-intermediated.
You know healthcare has been protected from that model. But due to COVID, with the rising trust on virtual care, people are getting used to not seeing their doctors face to face. Their ability to just log on and get consult. That combined with the reach of these organization and this trend with the CMS in the direct contracting model now, I think it’s going to create a big danger.
To the account for that, the practices and ACOs should really have to start thinking of a virtual infrastructure which can drive both revenue for them as well as protect them from these impending changes.
John. P Schmidt: How can ACOs help their physicians practice members from being overwhelmed by data analytics, quality metrics reporting, documents requirements, etc.?
Dr. Mansoor Khan: There are couple of points to highlight within this question: one is integration as I have mentioned before it is all about integration!
Here I am going to beat my own drum a little harder, as we have invested over 60 million dollars in truly bringing a single consolidated longitudinal patient record that takes the data from EHRs, from HIEs, and then social economic data, patient reported data, device data, claims data. We’ve managed to put all of that together at the physician desk. So now you make sure that you can deliver the right insight that a physician needs for the patient they are looking at that point in their EHR.
If you can connect those 2 things, for instance, the physician is looking at Mr. Jones and the system brings the information about Mr. Jones from all the different sources out there and runs it through an AI engine for the right insight. You are there!
The next generation of AI is physician driven that is designed by physicians, for the use of physicians and it thinks the way physicians think. It doesn’t tell them what to do but helps them in bringing the right data to the front. Those 2 things, an integrated approach that brings everything to physicians desktop, with the use of latest technologies that allows to filter out the most critical things to the front. Every detail available to the physician so that they can dig data as much as they want. This is the key. And we have been preaching it for almost 15 years now. The world is finally coming to the idea where we have been investing all our time and energies!
John Schmidt (MBA, PHD, CO Founder and executive vice president, ACO Virtual Exhibit Hall Gainesville, FL) – The moderator of this panel discussion on Advancing value based care
Dr. Mansoor Khan: ScD, CEO, Persivia, Malborough, MA
Brent Staton: MS, MD, CEO, Cumberland Center for Healthcare Innovation (ACO), Cookville, TN
Larry Jones: CEO, Physicians Collaborative Trust ACO, Maitland, FL
Eric Waver: DHA, MHA, Exectutive Dirctor, Accountable Care Learning Collaborative, Austin, TX