Making true progress toward value-based care requires buy-in and understanding from physicians—and for them to be willing to find common ground with insurers for collaborating.
With that backdrop, industry giant UnitedHealth Group partnered with the University of Minnesota's medical school to launch a four-week elective course that exposes fourth-year medical students to value-based care and has them working in person with Optum clinicians.
Kenneth Poole, M.D., chief medical officer for clinician and provider experience at UnitedHealth Group, told Fierce Healthcare that there's pretty broad agreement about the need to make a shift to value-based care, but there's far less consensus on what that actually looks like.
"Physicians probably can't give you a good definition of what exactly it means, including these physicians that are tasked with converting their practices from fee-for-service to value-based care," he said. If "doctors are still kind of scratching their head around what this means, then we know that we have an uphill battle as it pertains to rolling out some of these tenets and moving in that direction."
The first group of students recently completed their time in the course, and they felt that the class really pushed them to think critically about the healthcare system, David Satin, M.D., the director of courses in ethics, law and public health for the medical school and one of the co-directors for the joint course, told Fierce Healthcare.
He said the students, for example, had a pretty clear picture of what UnitedHealth Group was in their minds based on their negative impression of health insurers like its UnitedHealthcare segment. However, over time interacting with both Optum clinicians and national healthcare leaders, they saw far more nuance, Satin said.
"The students, they are not pushovers. They were giving the speakers the business," Satin said. "These students, to their credit, have been trained at the U that they can ask anyone tough but fair questions, so they pressed them on all sorts of issues."
"They got better at refining their questions, which really was a tribute to how much they were actually learning, both about content, but also, they were learning better context," he continued. "So part of the feedback was they themselves felt like their questions were far more nuanced and sophisticated by the end of the course."
Satin said the class includes three key components: one, practical time on-site with Optum clinicians; two, weekly meetings with guest speakers; and three, time set aside to debrief on what they've learned. Throughout the course, the students are tasked with deploying these lessons by building a final project examining financial aspects of their chosen medical specialty, he said.
Poole was on hand for question and answer sessions, too, and was able to put UnitedHealth Group's work into broader context as students interacted with key leaders, Satin said.
Poole said that opening the students' eyes to the wider story of UnitedHealth Group also highlights the broader complexity of the overall health system—a key lesson for them to learn before they go into practice. He said he saw firsthand the students developing that understanding through the course.
"You saw their perspectives change, and their questions, their inquiry, their comments, be more informed into realizing how broad this company is ... and not only this company, but the healthcare system that this company operates in," Poole said.
He said that UnitedHealth intends to work with the university again to offer this course to future students, and the team is also weighing other ways it can interact with medical trainees along the continuum of education to expose them to materials on value-based care.
Poole added that this type of education is not only valuable to medical students but also students pursuing degrees in business, public policy or public health.
As the university faculty and UnitedHealth Group teams look to the future, the first iteration of this course highlighted how critical it was for students to have time to debrief and go back through what they've learned, fully processing it, Satin said. The course wouldn't have worked, he said, if they were just shipped off to UnitedHealth without the rest of the experience built in.
It was also crucial to success for the program to marry the financial and payment-focused content with lessons on leadership, he said. Making that work was a "big win" for the initial course, Satin said.
"As we expand, we really take that lesson to heart, that it takes a real partnership to do this," he said.