Earlier this month, a few members of the Healthjump Healthcare Organization team, Dane Rasmuson and Calli Styczynski attended the Florida Association of ACOs (FLAACOs) 2022 Annual Conference.

This article explores some of the valuable insights they gained from the nation's leading experts in value-based care.

"FLAACOs was the perfect combination of a well-established yet personal conference." -Calli Styczynski, Healthjump Business Development Representative.

Current State and Future Trends of Healthcare

Chairman of the Board and CEO of FLAACOs, Nicole Bradberry, welcomed attendees to the conference on October 18th, 2022. She spoke about the current state of healthcare and how it is rapidly changing. 

Here are a few key takeaways:

  • The senior population is multiplying, which presents an opportunity to expand into the Medicare Advantage market.
  • It is becoming crucial for healthcare systems to provide high-quality care at lower costs, causing the market to shift from fee-for-service to value-based care. 
  • 2 out of 3 physicians are becoming burnt out or selling, which can be caused by several different things, including increased regulations, low reimbursement rates, high overhead costs, and more.
  • Direct contracting provides opportunities for physicians seeking independence and freedom from bureaucratic red tape.
  • Primary care providers (PCPs) are tenacious for patients (less than 4% churn annually between PCP and ACO providers).

Why Pharmacists are Essential in Value-Based Care

Sanjay Doddamani, Co-Founder & CEO of UpStream, discussed the importance of pharmacy in value-based care during his session titled "Our Future is within REACH! Success in the Next Generation of Value-Based Care.”

Value-based care aims to improve the quality of healthcare while lowering costs. The CMS Innovation Center stated that all payments in primary care need to be value-based by 2030.

As a result of inadequate patient education, unnecessary hospitalizations and doctor visits are occurring, increasing the overall healthcare costs for patients.

As healthcare providers transition into value-based care models over the next few years, Sanjay emphasized how essential it is to have a pharmacist on-site. Before patients leave the facility, pharmacists can properly educate them on medications and treatment plans, reducing the risk of medication misuse and return visits to the office.

How Health Equity Impacts Value-Based Care

Todd Stivland, MD, CEO of Bluestone Physician Group, discussed his accountable care organization’s approach to care and its focus on health equity during the session titled “Health Equity – VBC Realizing Equity, Access, and Community Health. Will it Really Impact the Benchmark?” 

Bluestone Physician Group is a value-based enterprise focusing on health equity for individuals with disabilities and chronic conditions. Each of their patients will experience a customized care approach to ensure they are receiving high-quality care at a price they can afford.

In a recent example, a disability prevented one of their patients from receiving routine medical services. With the help of several other accountable care organizations, Bluestone Physician Group put the patient under anesthesia, allowing medical professionals to perform several procedures simultaneously, ensuring the patient's comfort and reducing the number of office visits needed. 

Value-based enterprises like this allow CNAs, nurses, nurse practitioners, and other medical professionals to align forces and achieve their value-based care goals.

Improving Physical, Mental, and Behavioral Health Through Collaboration

People's overall physical health is negatively affected by mental health issues, such as anxiety and depression.

A session titled “Creating Mental Health Integration and a New Front Door. Understanding the True Impact of Behavioral Health to Traditional Health Outcomes” presented by Emilie Ventura, Kim Ho, Steve Biljan, and Jeff Spight discussed how primary care physicians can help facilitate access to behavioral and mental healthcare services for individuals post-pandemic through integrated care and co-location.

Integrated care is a collaborative healthcare model where healthcare professionals communicate to solve all of a patient's existing health issues, including mental and behavioral health. Through integrated care models and co-location, a patient can easily be referred to a behavioral health clinician or a psychiatrist within the same network, and potentially in the same location as their primary care physician.

When healthcare professionals communicate directly with one another, it removes the burden from the patient, and the percentage of follow-throughs on referrals significantly increases. Without these models in place, on average only 15% of patients follow up on their referrals.

Collaborative healthcare models are not only beneficial to patients, but they also help reduce PCP burnout, which as we mentioned above, is a rising issue in the current state of healthcare.

“The speakers at FLAACOS were incredibly engaging and I learned a ton about the future of healthcare while at the event.  I really like the idea of combining mental health care with traditional medicine.” -Dane Rasmuson, Healthjump Sales Executive.

How to Become a Successful Accountable Care Organization

During the session “Reaching beyond REACH: Administering and Aligning Innovative Payment Models for the Market” Nassib Chamoun, William Short, Dan Campbell, and Brian Kern, Esq. discussed how ACOs can become successful through utilizing the ACO REACH (Realizing Equity, Access, and Community Health) model.

This model promotes health equity and focuses on bringing the benefits of accountable care to Medicare patients in underserved communities. ACOs that follow the model can save up to 19%, on average.

To become a successful ACO, it’s important to keep the following factors in mind:

  • Small details can make or break the deal
  • Know your population
  • Review reinsurance contracts thoroughly, the language is extremely important
  • Affiliate with providers in various geographic locations to serve your patients
  • Know the insurance brokers in your areas
  • Employ additional apps like SMS, patient outreach, etc.

Threats to Traditional Primary Care and How to Solve Them

One recurring theme throughout FLAACOs 2022 was that patients are looking for access, convenience, and affordability when seeking care. Amazon, Walgreens, CVS, and Walmart are becoming major players in the healthcare space, and are disrupting traditional primary care because they have the ability (and funding) to provide all three. 

Patients are also increasingly choosing their homes as the primary care setting. A recent survey from Citrus ACO showed that 95% of their patients would rather see a provider at home.

Through recent acquisitions, these larger companies are appealing to that preference as well:

  • Walgreens acquired Village MD and CareCentrix
  • Amazon acquired One Medical
  • CVS acquired Signify Health
  • Humana acquired Kindred

With 54% of people using Telehealth over the past year, companies are aiming to become closer to patients through technology. Not to mention, they also have a greater ability to integrate technology in the delivery of care compared to primary care providers.

Although, there are several ways that traditional primary care providers can add value and compete against these larger companies:

  • Focus on expanding the Doctor-Patient relationship. 
  • Focus on educating the patients and their families.
  • Continuity of care.
  • Create easier access for patients by offering after-hours care and weekend hours. 
  • Focus on early detection and treatment of disease.
  • Offer in-home care options.
  • Increase marketing efforts for in-home care. 
  • Use Healthjump to get standardized data from across EHRs in minutes.

How Social Determinants of Health Create Challenges in Value-Based Care

Hillit Meidar-Alfi, Ph.D., founder, and CEO of Spatially Health focused on the challenges created by Social Determinants of Health (SDoH) and how to address them in the session titled: “Changing Landscape of Quality Metrics and Its Impact: Approaching a Cliff” where she spoke alongside Healthjump’s Director of Product Delivery, Laura Stewart.

A variety of factors can impact the cost and quality of a patient's care, including access issues, language barriers, transportation, or belonging to a minority. In many cases, patients are not able to discuss these issues due to extremely short appointments.

Spatially Health prioritizes and helps solve that issue by using data to locate individuals that need assistance due to SDoH, and helps align them with the right service providers and services to further drive patient engagement. 

Why Data is Essential in Value-Based Care

During the session “Changing Landscape of Quality Metrics and Its Impact: Approaching a Cliff” Healthjump’s Director of Product Delivery, Laura Stewart addressed the importance of data in value-based care. She took a deep dive into what direction, frequency, standards, and methods you can use to deliver your data. 

In addition to explaining how you can prepare your data, she also discussed what technologies you can invest in to do so, and how Healthjump can help solve commonly encountered interoperability issues. Her part of the presentation was highly interactive and involved the audience through an extensive Q&A session.

Regardless of your situation, data is crucial to the work and outcomes of value-based care organizations. Healthjump manages the collection, storage, and movement of clinical and financial data between EHRs, applications, and healthcare organizations.

Contact our team of data experts to learn more about how we can help you!