Better Health Care, Rewarded Better: It Takes a Village

Communities today are grappling with how to get better health care – and howMiles Snowden, MD, MPH, CEBS Chief Medical Officer, OptumHealth to better reward it. To do this, it will take a partnership between payers, vendors and key providers. Physicians shouldn’t feel that they need to go it alone in the development of sustainable, value-based reimbursement initiatives. As they say, it takes a village.

The key to success for physicians is a purposeful, inclusive dialogue, working through several questions, in order:

  1. Governance & Structure – How will decisions be made?
  2. Physician Engagement – How will physicians gain insight and be stimulated to embrace best practices and opportunities for improvement?
  3. Information Technology – How will the full delivery system be sufficiently connected and intelligent?
  4. Clinical Performance Management – How will physicians be enabled to actually make better decisions, at scale?
  5. Population Health Management – How will plan members be empowered to make better decisions?
  6. Clinical & Financial Risk Management – How will risks to favorable clinical and financial outcomes be identified, measured – and then eliminated, modified or mitigated?

The “village” concept comes into play as physician organizations begin to struggle with each of these six steps. While it may not come naturally for doctors, they need input from payers and vendors (consulting, technology, analytics, population health management and risk mitigation suppliers). Payers and vendors can facilitate, support or even consult on governance, structure and physician engagement. They can distribute or engineer services when it comes to information technology, clinical performance management and population health management. And they can either mitigate or hold risk in various forms.

As a bonus, vendors can often serve as a neutral “organizer” in the earliest stages of these dialogues: They are neither payer nor provider, and they have an informed point-of-view on best practices in these collaborations.

The message for physicians is clear: To produce sustainable improvement in the health care system, don’t be afraid to embrace your health care “village.”

Miles Snowden, MD

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