Health system shares lessons learned from its shift to value-based care

care team

A successful North Carolina health system transformed its care model by focusing its efforts on serving its highest-risk patient populations. A year later, they’re already seeing improved results.

Even though Cornerstone Health Care was profitable, technologically progressive and cost-efficient under the fee-for-service payment model, its leaders didn’t see a future for its productivity-oriented mindset in the changing healthcare market, write Grace Terrell, M.D., founder and strategist for Cornerstone Health Enablement Strategic Solutions, Bruce Hamory, M.D., chief medical officer at consulting firm Oliver Wyman, and Josh Michelson, a partner at Oliver Wyman, in an article in H&HN. After surveying its options, the group undertook a complete restructuring and built two new clinics. They focused on multi-disciplinary teams, incorporated full-time primary care physicians into models focused on specific conditions and added facilities to manage behavioral and population health.

After a year, Cornerstone saw a decrease of almost 13 percent in the total cost of care and reduced inpatient hospital costs by 30 percent. The authors shared their lessons learned for other organizations interested in a similar transformation:

  • Don’t be afraid to commit. Value-based care works because it’s “designed to fix the problems and seize the opportunities associated with narrowly defined groups of people,” the authors write. The size of that change can mean redesigning a practice from scratch.
  • Bring all stakeholders on boardRadical transformations are disruptive, so Cornerstone had to work with its payers and its staff to get buy-in from all of its stakeholders.This took extra effort where payers balked at alternative payment contracts, or where physicians needed to change their approach to patient encounters, according to the article.
  • Acknowledge that efffective transformational change doesn’t happen incrementally. Cornerstone’s attempts to nibble around the edges of value-based care with care coordinators, increased generic prescribing and reducing unnecessary tests actually raised costs compared to the areas in which the group implemented complete programs, according to the article.