Ep 177 – Unveiling the Vanguard of Value-Based Care Research and Innovation, with David Muhlestein

The Race to Value Podcast

08-08-2023 • 1 hora 3 min

Peering into the horizon of healthcare, we unveil the vanguard of value-based care research and innovation, where data-driven insights and daring ideas converge to shape a healthier tomorrow. In the ever-evolving landscape of healthcare, trailblazing research serves as the guiding light that illuminates the path toward a value-based care revolution. By delving into the intricate dynamics of accountable care, dissecting payment models, and exploring innovative strategies, research on healthcare transformation provides the foundation upon which healthcare stakeholders can build a more equitable, efficient, and patient-centered future. This work not only dismantles traditional barriers but also empowers policymakers, providers, and patients to collectively navigate the complex journey toward a value-driven healthcare paradigm. Our guest this week on the Race to Value is none other than the esteemed David Muhlestein, PhD, JD a true trailblazer in the field of value-based care research and innovation! With a passion for accelerating the adoption of accountable care and driving meaningful change, David has dedicated his career to unraveling the complexities of the value movement by telling a story with data.  As the chief research and innovation officer at Health Management Associates (HMA), David Muhlestein’s research and expertise centers on health care payment and delivery transformation, understanding health care markets, and evaluating how the broader health care system is changing. In this interview, we cover topics such as the value-based care movement and the goal of speeding the uptake of accountable care; the current growth trajectory of ACOs; payment model reforms that are taking place to advance health equity; the positioning of Medicare Advantage in the accountable care landscape; the inclusion of specialists in value-based care; multi-payer alignment to reduce administrative burdens and increase the impact of accountable care reforms; hospital and health insurer price transparency; and the new Primary Care Alternative Payment Model ("Making Care Primary").   Episode Bookmarks: 01:30 Introduction to David Muhlestein, PhD, JD – one of the nation's leading value-based care research executives. 03:30 Support Race to Value by subscribing to our weekly newsletter and leaving a review/rating on Apple Podcasts. 04:30 The glacial pace of scaling payment model transformation and CMS’ goal of speeding the uptake of accountable care. 05:30 Industry challenges (e.g. supply chain disruptions, labor shortages, inflation, financial distress) that complicate value-focused investments. 07:30 The plateau of accountable care growth over the last three years in terms of total number of participating ACOs and lives covered. 08:30 The business model for value is supported by payment mechanisms, unique population health capabilities, and playbook approaches. 09:30 Who is really the customer of a health system?  (Is it the patient, the health plan, or physician practices that drive referrals?) 10:30 The capacity-focused world view of a FFS model – creating capacity for well-reimbursed services and then driving transactional patient volume. 11:00 The population health focus of VBC and how that creates conflicts within health systems optimized for fee-for-service capacity. 14:00 Changing the reality of an organizational culture dominated by FFS is increasingly more difficult in a post-pandemic economy. 15:30 Has anyone else noticed that the VBC solutions vendors at healthcare conferences are less predominant in recent years? 16:00 “When times are tough, organizations revert to the lowest common denominator that is their underlying business model.  That is the current challenge for value transformation.” 17:00 Recent stats on the growth trajectory and overall savings of Medicare ACOs over the last few years. 19:00 Average savings in the MSSP (after bonus payments) is about 1% relative to the projected benchmark.

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