In part 2 of our interview, John Wallace, vice president and general manager at Web2pro Business Performance Services, shares insights on how health care organizations can smoothly transition from volume to value-based care. Read
part 1 of the interview.
How can health care leaders successfully navigate the shift from volume to value-based care, particularly during the transition when both reimbursement methods may be used?
Wallace: That’s the crux of the issue. For the foreseeable future, health systems will have both volume-based and value-based care. The provider organization, physician contingent and health system have to agree on certain elements and sharing. For example, they may establish gain-share contracts where there’s still a fee-for-service model for a visit but the contract incorporates benchmarks that address patient readmissions.
How can organizations identify who would benefit most from working with a care coordinator and multidisciplinary team?
Wallace: Most health care organizations understand that certain disease states need to be managed more appropriately, such as congestive heart failure, diabetes and COPD — disease states that end up costing the system a lot of money. These are important to identify early, and the best way to identify those patients is to have the right technology platform and partners who are willing to share that information.
Why is it important to patients that health care organizations transition as quickly and efficiently as possible?
Wallace: Today we’re more aware of what we’re paying when we see a provider, and that shift to consumer-driven health care has a tremendous impact on consumer buying behavior. The education we provide patients about the value-based care model will help ACO success. Engaging consumers is and will continue to be critically important.
What kinds of benefits will teams see from the shift to accountable care when they are treating patients who have complex, chronic illnesses?
Wallace: Health care teams will benefit when they see patients living a healthier lifestyle. If you’re part of a health care team, you’re driven by the quality of care you’re delivering to patients. If you see a financial benefit to a program, and your patients are saying “We love you, we’re healthier,” that’s the best outcome — people living longer and enjoying life more.
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Accountable Care Services Playbook.