Panelists highlight care options unavailable under fee-for-service model.
Despite its challenges, value-based care has shown great promise in improving health outcomes and access to care, particularly among traditionally underserved or high-risk patient populations.
That was the view of participants in the panel discission, “The Risky Business of Value-Based Care" at the 2022 HLTH conference in Las Vegas. Panel moderator Sara Pinto, a partner in the venture investment firm Emerson Collective, began by pointing out that currently only about 20% of Medicare reimbursements are value-based. But given the flaws in fee-for-service medicine, “in a lot of ways we need value-based care to work, and we all hope it will.”
Panelist Corbin Petro, co-founder and CEO of Eleanor Health, a company that provides mental health and substance abuse services, said that 90% of the population they serve are not connected to primary care. “We know we can engage with this population and improve the health, but we can only do it by taking on financial risk,” she said. “I think that’s the promise of value-based care, especially for populations that the health care system traditionally has left behind.”
Her view was echoed by Ali Khan, MD, MPP, chief medical officer for Chicago-based Oak Street Health, a network of primary care providers. “To me, the importance of value-based care is its ability to provide primary care where it didn’t exist,” he says, noting that Oak Street is the only health system to serve Chicago’s largely impoverished west side.
The same was true for many of the communities served by Khan’s previous employer, Iora Health. “These are places the medical-industrial complex has largely failed,” Khan said. “So if nothing else, value-based care has incentivized companies like ours to go into places that otherwise haven’t been touched by the health care system.”
Aaron Friedkin, MD, chief business officer for Homeward, a provider of health caree services to people in rural areas, says that by enabling his company to take on risk for large patient populations, “we can make investments to expand access to care deploying technologies and care models that may not be reimbursed under fee-for-service but that allow us to overcome many of the structural barriers to care found in many rural areas.”
Panelists also stressed that without the time constraints of fee-for-service medicine, their providers can take the time to get to know patients and build the trusting relationships necessary to provide high-quality care.
“You have to understand what’s top of mind for a community, and that’s not always health care,” Friedkin noted. “It could be ‘how do I pay my bills’ or ‘how do I get where I need to go?’ Knowing those kinds of things requires understanding not just the health needs of a community but everything that’s going on in their lives. If we show we can help with those issues is how we earn trust and the right to care for them.”