Attendee Feedback: How to Develop Value-Based Partnerships

In breakout discussion groups, attendees were asked to offer input on key issues to address when developing value-based partnerships.

Here are four vital questions and the respective attendee answers.

What do health plans, hospitals, physicians, and employers collectively need to do to form a successful value-based relationship?

• Understand the goals and vision of each entity at the start of discussions.
• Learn about the culture of each organization when coming together. No one organization can have authority over other entities in the relationship; the relationship must be collaborative.
• Establish common goals for care coordination and efficiency of care to achieve quality.
• Establish trust and transparency with all stakeholders.
• Share common data.
• Remain open-minded, but agree to disagree.
• Redefine roles up front; traditional roles should shift. Communicate often and effectively. Dedicated resources will be needed to ensure that communications between stakeholders are timely.
• Offer education for all parties to help structure the new culture of collaboration. Define the infrastructure and dedicated resources from both a provider and a health plan perspective. A medical group and chief medical officer should be part of conversation.
• Plan and structure the relationship using shared accountability.

What obstacles could potentially impede success?

• Built-in silos within organizations
• Inconsistent communication
• Governance limitations or technical challenges in sharing information
• Poorly defined strategy or plan design (resulting in a lack of focus on the patient)
• Lack of technology (or an inability to utilize it effectively)
• Lack of engagement among partners (are the right people at the table?)
• Ineffective care management
• Financial challenges (given that “the pie is not getting any bigger” and getting additional cost out of the system may be a formidable challenge)
• Potential risks to previous capital investments
• Regulatory, regional, state, and national uncertainty related to the impact of the Affordable Care Act, the Medicare Access and CHIP Reauthorization Act (MACRA), etc.
• Cultural issues in implementing changes to move to value
• Cost pressures, particularly for small community hospitals
• Clinical variation
• Narrow-network characteristics that may create access issues and perception problems for employers

What characteristics or capabilities are necessary for success?

• Data: integrity, timeliness, ability to interpret and use
• Acceptance of data
• Transparency. Early wins to build trust and momentum
• Champions/leaders to drive the effort
• A patient-centered approach by all stakeholders

What are the limiting factors that each partner must overcome within its organization to build  success in a value-based partnership? 

• Fear of change among organizations and people
• Difficulty with the sharing and integration of data
• Not having a defined set of quality metrics
• Lack of access to an adequate volume of live data as opposed to claims data
• A short-term focus as opposed to a long-term strategic perspective
• Limited workforce supply (are there enough physicians?)