Value-based care models: Look to strategies that already work

Intermountain, Mayo Clinic make bets that pay off in the long term
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The transition to a value-based care model is easier said than done. To actually make such a model work, leaders should look to practical strategies that have been successful for other organizations, according to a blog post for NEJM Catalyst.

These organizations' strategies have one common theme, write Thomas H. Lee, M.D., chief medical officer at Press Ganey Associates, and Laura S. Kaiser, executive vice president and chief operating officer for Intermountain Healthcare. They all require that hospitals take an initial financial hit for a long-term payoff through improved quality of care, better use of time and a positive effect on provider culture, which in turn reduces turnover. 

The choice to improve care value over time rather than turn a bigger fee-for-service profit in the short term is the principle at the heart of the value-based model, they write. These providers and other pioneers in value-based care say such strategies are important for several reasons, including:

  • Relationship-building
  • Sustainability
  • Risk-management experience

For example, Intermountain Medical Group has integrated mental healthcare into its primary care services for nearly two decades, they point out. Intermountain's primary care patients receive screening for mental and behavioral health issues. Since implementing this model, declines in use of inappropriate emergency care and other services have slashed costs by $115 per member.

At Minnesota's Mayo Clinic, cancer surgeons consult with pathologists during lumpectomies or partial mastectomies rather than waiting days to get results back, they write. This strategy allows surgeons to determine the status of the cancer and how to move forward by the time the procedure is finished. This eliminates the need for a further lumpectomy 96 percent of the time, making a steeper short-term investment in exchange for long-term cost reductions and improved peace of mind for patients.

"The leading providers are taking an 'all in' innovative approach as they do the hard work of developing new organizational competencies and nurturing cultural change from within," the essay states. "Their new high-value models will give them a clear advantage over institutions that fail to act strategically now."

To learn more:
- read the blog post

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