Value’s Future is alignment
When we know something works, we ought to do it. But what if we think we know what works, or that it could work if we did enough of it?
This is the paradox of testing and scaling that has been value-based care for the past decade. Recent reports highlight the growing importance to providers of payer alignment to support implementation of value-based care and population health.
The HCP-LAN Multi-Payer Alignment Blueprint spells out clearly that alignment takes hard work over time. The blueprint examines key lessons learned from efforts across four states: Arkansas, California, Colorado, and North Carolina. The report highlights upstream efforts and infrastructure that can support alignment such as: adopting shared goals, identifying a central coordinator or convener, developing a partner engagement strategy, and following it through with monitoring and technical assistance.
Next, the Health Care Transformation Task Force | Building Better Benchmarks: Principles for Sustainable Benchmarking in Value-Based Care (hcttf.org) emphasizes designing in collaboration across payers, providers and communities, with transparency in support of a sustainable business case for participants that prioritize the shared aims of quality and patient experience.
Finally, together with our colleagues at Aurrera Health Group, we supported AHIP, the AMA, and NAACOS in the first of what will be ongoing efforts across these national groups to engage their members in developing a playbook for sustainable value-based care. The first installment, Voluntary-Best-Practices-to-Advance-Data-Sharing.pdf (aurrerahealth.com), focuses on the need for creating interoperable data ecosystems, sharing complete patient data in standard ways, improving data collection and use to achieve health equity, making data actionable, and increasing the transparency in how data is used in methodologies and calculations.
While each report addresses different aspects of the value-based care ecosystem, it’s easy to spot the cross-cutting themes. Collaboration, space to focus on shared goals, access to comprehensive data, and transparency are integral, but the underlying mega-theme is that doing this differently in Medicare, Medicaid, and commercial insurance is unsustainable. Can you imagine if any of these reports had recommended different best practices for every payer-health care provider combination, different best practices in every state, different for each and every patient population? We know you don’t have to imagine because that’s where we are today.
The way forward is simple.
· Public policy champions alignment as a core principle of model development
· Private sector commits to alignment
· And together, public and private sectors, make space for shared learning and technical assistance to support alignment and keep after it.
Simple does not mean easy, but there are roadmaps, blueprints, and playbooks a plenty to make progress.