Survival in today’s value-based health care industry takes trust — in people, technologies and business processes. Trust is the “secret sauce” that brings everything together, said health care futurist Joe Flower in the Spring/Summer edition of Optum RISKMATTERS.
Volume to value, the shift from doing fee-for-service medicine to taking a financial risk in one way or another on the health of the populations you serve, means a major shift in revenue streams, costs, and most importantly partners, Flower said. Taking on risk means you need partners you can trust, including partnerships that may be beyond the experience, training, and even comfort zone of many people who currently run health care organizations.
“How do you handle that? How do you survive in a world in which you are sharing risk? How do you survive by preventing the large acute cases that used to be your biggest sources of income?” Flower said. “It’s not easy, and is likely impossible to do alone.”
The technical parts of succeeding under value-based care are difficult. What kind of corporate structures, joint ventures, revenue- and cost-sharing arrangements should you build? What kind of risk structures and reinsurance schemes should you employ? How do you coordinate information structures across institutional lines? All of the above requires trust, from everyone involved. Flower recommends several strategies that build trust, from patients to clinicians to administrative staff:
It takes a village—Value-based risk means managing the health of entire populations, not just treating the disease of one individual. Patient populations must trust that you’ll do right by them, and that confidence must be seamlessly extended to clinicians and support staff.
- Be an active team member —Disease and population management programs fail when providers insert an outside third party — for example, a call center employee or contact who doesn’t understand population needs — to handle care coordination. This short circuits trust. Real change in patient behavior happens only in the context of trusted relationships.
- Divide and “concur” —Effective population health management and prevention requires establishing trusted relationships with all of the population. Since people are in many different situations, this means you have to divide the market, and target strategies to specific parts of it.
- Look within — Trying to build a broad seamless organization without building trust, or trying to cost-cut your way forward at the expense of trust, is simply bad management. In health care much more than other businesses, trust is the glue and fuel of the organization.
- Conduct trust audits — Gather information by actually asking people what their experience is through focus groups, surveys, and interviews. Find the gaps. Never tell yourself a story about why they should trust you. That’s not helpful. Find out where they don’t, and then explore how you can change that.
Building trust is an effective way to manage risk under value-based care. To read Flower’s full article, download the latest edition of RISKMATTERS here.
About the Author:
Anu Sharma, MD, MHA, MS
SVP, Network & Population Health Consulting
Anu Sharma, MD, MHA, MS, is the Network and Population Health Consulting lead for Optum. He has 20 years of healthcare experience and has been in healthcare management consulting for about 13 years, primarily focused on “middle office” solutions and offerings (i.e., care management, network management, quality and clinical informatics) for health plans, population health and payment solutions for providers, and related solutions for PBMs and employers.