Capabilities Needed for Value- Based Care · Greg Howe Senior Program Officer Center for Health...
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Advancing innovations in health care delivery for low-income Americans www.chcs.org | @CHCShealth Capabilities Needed for Value- Based Care Population Health Learning Network January 16, 2019 Rob Houston and Greg Howe
Transcript of Capabilities Needed for Value- Based Care · Greg Howe Senior Program Officer Center for Health...
Advancinginnovationsinhealthcaredeliveryforlow-incomeAmericans
www.chcs.org|@CHCShealth
Capabilities Needed for Value-Based Care
PopulationHealthLearningNetworkJanuary16,2019RobHoustonandGregHowe
About the Center for Health Care Strategies
Anon-profitpolicycenterdedicatedtoimprovingthehealthoflow-incomeAmericans
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Presenter Introductions
RobHoustonAssociateDirector,PaymentReformCenterforHealthCareStrategies
GregHoweSeniorProgramOfficer
Bytheendofthissession,yourhealthcenterwillknow:¡ Fourcapabilitiesneededtosucceedinavalue-basedpayment(VBP)environment
¡ HowtoconnectthesecapabilitieswithyourcurrentandfutureVBPefforts
¡ Howtoeffectivelycommunicateavaluepropositiontostaff,partners,MCOsandotherstakeholders
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Session Objectives
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Advancinginnovationsinhealthcaredeliveryforlow-incomeAmericans
What are the Capabilities?
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1. Implementingcaremodelstomanagecomplexpatients
2. Usingdatatosupportcaredelivery,improvequality,andreducetotalcostofcare
3. Coordinatingeffectivelywithexternalprovidersandcommunitybasedorganizations
4. Buildinginternalandexternalsupport
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Capabilities Needed to Succeed in VBP
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Implementing care models to manage complex patients
EffectiveCareCoordinationModels:¡ Aredesignedoradaptedtomeetuniquehealthcenterneeds
¡ Arebuiltaroundteam-basedcare¡ Integrateclinicalguidelines,bothinternallyandacrosssites
¡ Incorporatechangesintheworkflow¡ Utilizeadesignatedcarecoordinatoron-sitewithclearrolesandresponsibilities
Essentialcapabilities:¡ EMRtosupportcarecoordinationandtocapturedata
¡ Trainingandmonitoringtoensureaccuratecoding
¡ Availabilityoftoolstoperformdataanalysis¡ Definedstaffpersontomangequalityreportingandmonitoring
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Using data to support care delivery, improve quality, and reduce total cost of care
Advancedcapabilities:¡ Abilitytosharedatawithexternalentities¡ Availabilityofadatawarehousetosupportdatasharingandanalyticsthatwouldinclude:EMRclinicaldata,payerclaimsdata,admission,discharge,andtransferdata
¡ ITtoolsformanagingcareinrealtime:e.g.dashboards,sharedcaremanagementplans
¡ Analyticstotrackattributedpatientsandassesstotalcostofcareoutsideofhealthcenter’swalls
¡ Predictivemodeling9
Using data to support care delivery, improve quality, and reduce total cost of care
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Coordinating effectively with external providers and community based organizations
HealthCentersareableto:
¡ Developandmaintainrelationshipswithexistingandnewpartners,includinghospitalsandotherprovidergroups,e.g.specialistsandbehavioralhealthspecialists
¡ Trackandunderstandwherecareisdeliveredoutsideofitswalls
¡ Createsharedcaremanagementplans
¡ Managetransitionsofcare
¡ Shareandactondatainrealtime
¡ Workwithcommunitybasedorganizationstoidentifyandaddresssocialdeterminantsofhealth
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Building internal and external support
HealthCenterLeaders:¡ UnderstandVBP:canarticulatevision,addresscontractingandimplementationchallenges
¡ ActivelysupportVBPeffortsinternallyandinthecommunity
¡ Buildcollegialityamongstaff¡ Clearlycommunicatechangestostaff¡ Developclearrolesandprocesses¡ Engagehealthplanstoidentifysharedgoals,coordinateresources,addressdatachallenges,patientattribution,etc.
¡ Engageexternalstakeholders:patients,otherproviders,communityleaders
¡ Manyofthesecapabilitiesarejust“goodcare”» ThesecapabilitiesarethetoolstosucceedinVBP,butalsojustwaystoimprovequalityandlowercostsforahealthcenter
» EvenifthereisnoVBParrangementcurrentlyinplace,itisagoodideatodevelopthesecapabilities
¡ Shouldn’thealthcentersbepaidinawaythatincentivizes“goodcare”?» CurrentPPSratesareencounter-based,notvalue-based» VBPcanhelptoimproveyourpracticeanditsperformancebyaligningpaymentwithgoodcare/thesecapabilities
¡ However,toenterintoaVBParrangement,manyprovidersneedtobuildabusinesscaseforinternalandexternalstakeholders
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Why are These VBP Capabilities Important?
WhatareYourHealthCenter’sCapabilities?
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Group Discussion
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How to effectively communicate a value proposition to partners, MCOs and other stakeholders
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¡ “Valuepropositionreferstoabusinessormarketingstatementthatacompanyusestosummarizewhyaconsumershouldbuyaproductoruseaservice.Thisstatementconvincesapotentialconsumerthatoneparticularproductorservicewilladdmorevalueorbettersolveaproblemthanothersimilarofferingswill.”(Investopedia)
¡ ValuePropositionstypicallycontain:» Anexplanationofhowtheproduct/servicesolvesaproblem» Specificbenefits» Pointsofdifference/competitiveadvantages
¡ Itisnota“missionstatement”–avaluepropositionsellsyourproduct/service
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What Is a Value Proposition?
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Value Proposition Example
¡ KNOWYOURAUDIENCE» Whatoneaudiencevaluesisn’tnecessarilywhatanotheronedoes
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The #1 Rule of Value Propositions
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Another Value Proposition Example
¡ ThinkaboutwhyyourFQHCexists» Whyareyouinbusiness?» Whatservicesdoyouprovide?» Whodoyouserve?
¡ Thinkaboutwhatmakesyoudifferent» Whatareyourbiggeststrengths?» Whoareyourbiggestcompetitors?» Whatdoyoudobetterthanyourcompetitors?
¡ Tailoryourmessage» Accentuateyourgreatestattributesforyourgoalandattunethemtoyouraudience19
How to Create a Value Proposition
¡ Itisnotataglineormotto» Itislonger,anddoesn’tneedtobecatchy–butyoushouldmakeitclearandsimple
¡ Whyareyouusingyourvalueproposition?» Inadditiontoknowingyouraudience–youneedtoknowwhatyouareaskingyouraudiencetodo.Whatactiondoyouwantthemtotakeaftertheysee/hearyourvalueproposition?
¡ Thereisnospecificformat» Dowhatworksforyou.Itcouldbeaparagraph,bulletpoints,orasimplephrase.Itcanbewrittenordeliveredverbally.20
Some More Value Proposition Tips
¡ FQHCnetworkinAllentown,PAthathadimplementedaCamdenCoalition-likeinterventionforhigh-need,high-costpatientstheyimplementedthroughaCMMIHealthCareInnovationAward
¡ Fundingwasrunningout–neededfundingfromMCOstocontinuethework
¡ Madesuccessfulpitchtostate’slargestMedicaidMCOby:» Usingdatatomakethecasefortheintervention» TalkingaboutthebenefitsthattheMCOcaredabout:(1)costreduction;(2)riskreduction;(3)qualityscoring
» Knowingtheiraudience:makingapresentationpersonalizedtothatMCOusingtheirpatients
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Making a Pitch: The LVHN Story
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Any Questions?
¡ EachofyouwillcreateavaluepropositionforyourFQHCtopresenttoanMCOinhopesofenteringintoaVBPcontract
¡ Rememberto:» WhydoesyourFQHCexist?» WhatmakesyourFQHCdifferentthancompetitors?» Simplifythemessageandattuneittoyouraudience» Itdoesn’tneedtobecatchy–focusonyourcorecapabilities
¡ Attheend….wewillberole-playing
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Value Proposition Challenge
¡ Whatarepracticalnextstepsyoucantaketoimplementtheseskills?» Assessyourcapabilities–strengthsandweaknesses» MakemeaningfulconnectionsbetweenyourcapabilitiesandVBPgoals» Developavalueproposition
¡ AdditionalhelpavailablefromCHCS» Technicalassistanceopportunities(Spring2019)
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What’s Next?
