How Plans Are Supporting Providers on Their Value-Based Care Journey

group brainstorming The pandemic highlighted the shortcomings of fee-for-service for many providers and spurred renewed interest in value-based reimbursement arrangements. Yet, while there is more willingness, many providers admit they are unprepared to take on risk.

World Congress recently hosted a panel discussion featuring industry experts discussing how health plans are helping providers transition gradually into value-based care models, sharing philosophies, programs, results and lessons learned.

Brian Wheeler, Vice President, Provider Collaboration and Network Transformation, CareFirst BlueCross BlueShield, participated as a panelist with Karen Amezcua, Senior Director, Provider Partnerships, Blue Cross Blue Shield of Minnesota and Oraida Roman, MHA, Vice President of Value-Based Strategies, Humana.

The panel, moderated by Lori Logan, Chief Product and Client Officer, Geneia, shared insights on the importance of applying a phased approach to accelerate success in value-based care arrangements, meeting providers where they are in their journey. Additionally, they discussed:

  • How plans and providers can work together on focused solutions that address immediate needs, early wins and ROI, and alignment on value-based and clinical goals
  • New value-based programs or initiatives developed during the pandemic, including those focused on primary care
  • Common challenges plans face (and solutions to overcome them) when working with their provider partners on value-based care arrangements
  • Ways to provide more insight into pandemic deferred care and how to help providers find and prioritize those patients

Read the full panel discussion recap in a recent Healthcare Innovation article.