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Embracing Risk to Reimagine Healthcare

The Centers for Medicare and Medicaid Services (CMS) announced in 2023 that by 2030 they want every beneficiary to be part of a risk-based model of care. A panel of industry experts including healthcare providers and partners spoke on navigating this change at the 2024 ̲app, Growth, Innovation and Leadership Experience (AGILE).

Shradha Aiyer, Vice President of Product Development and Engineering at ̲app, moderated the session with panelists Brent Korte, CEO of Frontpoint Health; Kim King, CEO of Home Care Network; Dr. Harry Saag, National Medical Director of Walgreens Health; and Dr. Cameron Berg, Executive Vice President, Clinical Strategy of Pearl Health.

The panel focused on how organizations can get started in value-based arrangements, gain insight into developing and managing a value-based “payvider” model and explore how technology is evolving to support risk-bearing organizations.

Get Started in Value-Based Arrangements

Shradha Aiyer started off the panel by asking Brent Korte about the initial steps organizations should take as they transition to a value-based care model.

“It depends on the way your organization is oriented,” Korte said. “If you have an orientation towards having a large salaried staff and you have to sort of fight the productivity battle every day, every hour, every second, then in my opinion, you build an army of generals. You work with your staff who are highly dedicated and you want them to stay.”

Korte also said that turnover is very important. “Keeping your turnover low is very important.”

Aiyer asked Saag what Walgreens is doing from a payer perspective to help improve the care delivery model. He explained that Walgreens is leveraging investments and finding ways to partner more closely with the rest of the ecosystem.

“Walgreens is here today because we recognize that the more we can connect the dots for patients, the less fragmented it will feel,” said Saag.

Develop and Manage a Value-Based “Payvider” Model

King discussed the strategies she has found most effective in navigating managed care contracts and supporting negotiations that empower providers.

“My advice to providers that are looking to start these kinds of conversations with managed care entities is you start with what you’re good at and that is hands in the homes and eyes in the home. Very quickly, you’re going to find that you need to identify how to extend your caregiver potential,” King said.

Berg felt that the shift to value-based care is coming at the right time for the care at home industry.

“If we go back and we look at its origins, I think it’s fair to say that [value-based care] started in a very top-down way,” said Berg. “Physicians kind of wrote the statutes. Fast forward ten years, I think a lot of things have become clear and some recognitions have been made…that top-down kind of white-coat-centered mentality was incorrect.”

Leverage Operations and Technology in Organizations

King explained how providing her staff with technology has helped them with visits and the delivery of information.

“We’ve found arming our staff with technology that allows them to do a virtual visit allows an aide to work at the high end of what they’re able to do so that they can give real information back to a clinician,” King explained.

“If we need to take it to the next step and get a virtual visit with a physician [or] arrange transportation to get somewhere, that makes all the difference in the world.”

In conclusion, “Understand what value means to the people. Figure out what the bar is and do better than that. Prepare for it and then prepare to be proactive and then be ready to be deeply, deeply reactive,” Korte said.

Learn more about the ̲app Growth, Innovation and Leadership Experience, also known as AGILE. Watch this of the 2024 AGILE conference.


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