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Innovative Care Delivery Models with Dr. Jordan Asher

The following article is a summarized version of some of the topics from Episode 3 of The Better Care Podcast with Sentara Healthcare Executive Vice President and Chief Physician Executive, Dr. Jordan Asher. Some quotes have been slightly edited for brevity.

Dr. Asher and Dr. Fengler discuss the success and shortcomings of innovative care delivery models such as Clinically Integrated Networks, ACOs, and value-based care overall, while also covering physician burnout, digital health initiatives, and helpful leadership practices.

What is Value-Based Care?

Value-based care is a healthcare model designed to improve the quality of care and outcomes for patients while reducing costs and increasing efficiency. It’s a departure from the traditional fee-for-service model, which reimburses providers based on the quantity of services rendered, regardless of their effectiveness or impact on patient health.

“Instead of a fee-for-service model, value-based care is a shift towards a value based payment model, where we define and pay for value rather than units of service.” – Dr. Jordan Asher

Over the past decade, the healthcare industry has undergone a significant transformation, with value-based care being a major force in this change. And although value-based care continues to get a lot of attention, it’s not a new concept; it has been ongoing for about 12-15 years. The journey towards value-based care roughly began in 2011, with the Affordable Care Act’s introduction, which focused on improving the quality of care and lowering healthcare costs.

Does Value-Based Care Work?

Value-based care was created to align the cost of care with patient outcomes to benefit the payer, the provider, the patient, and society. The outcomes are difficult to measure, however, leaving the success of value-based care in reducing costs still in question.

“It has delivered on the value equation of quality and service divided by cost, but CMS has not received as much savings from their shared savings program as they would have liked. However, we must think of the other value-based care models, such as bundled payments and other reforms, and when you put them together, it has been successful.” – Dr. Jordan Asher

Dr. Asher describes the impact of Clinical Integrated Networks, a term he uses broadly to also include Accountable Care Organizations (ACOs), and that the shift in thinking caused by these care delivery models has moved us in the right direction – even if there’s still tension.

In terms of payment models, value-based care models often involve pay-for-value or bundled payments. These payment models encourage healthcare providers to deliver high-quality care and achieve positive outcomes, such as improving patient health or reducing hospital readmissions, to receive financial rewards. This incentivizes providers to focus on improving patient outcomes, rather than delivering more services, resulting in higher quality and lower cost.

“When you think about health care, and you think about balancing quality and cost, we tend to think of them as opposites… we ask which one is more important? That is the wrong question. They are both important. They are interdependent.” – Dr. Jordan Asher

The Challenges of Value Based Care

While there has been significant movement toward value-based care; it’s certainly happening slower than many would like. Healthcare providers and organizations are struggling to make big shifts in the delivery and payment of healthcare. The implementation of the value-based care model is hindered by several challenges. Some of these challenges include:

    • Value Based Care is an investment. The need to collect and analyze copious amounts of data to track patient outcomes and determine the effectiveness of different treatments requires a significant investment in technology and infrastructure, which can be costly upfront.
    • Societal norms and cultural disagreements. The conflicting beliefs that healthcare is a privilege versus a right, and the logistics birthed from that tension, leads to challenges in implementing and investing in the adoption of value-based care models at a macro level.
    • Measurement of Value. Concerns about the measurement of value in healthcare, how it’s defined, and data standardization can make it difficult to compare outcomes across different providers and organizations and determine the effectiveness of different treatments and interventions.

“Value-based care has been a challenge for our society because we do not agree on whether basic healthcare is a right or a privilege. While healthcare is a right from a regulatory and legal standpoint, the debate creates friction between individualism and public policy issues. Managing these dynamics is necessary for value-based care to succeed.” – Dr. Jordan Asher

Despite these challenges, value-based care is a journey that the healthcare industry must continue to undertake to improve the quality of care and outcomes for patients. By incentivizing providers to focus on improving patient outcomes, rather than delivering more services, value-based care can lead to higher quality and lower cost care.

“This journey towards value-based care has been ongoing for about 12 years, and we have learned a lot and continue to do so. As someone who sees the glass as three-quarters full, I believe that creating value-based payment and care models is the right path forward.” – Dr. Jordan Asher

To hear the full episode of Dr. Jordan Asher’s approaches to implementing value-based care, listen to Episode 3 of The Better Care Podcast, available now on all major podcast platforms.