Industry Innovations Lead to Unexpected Challenges

The biannual Deloitte Health Care CEO Perspectives Study interviewed 31 healthcare CEOs to gain a better understanding of the successes, challenges, and responsibilities faced by health systems and payors. It is through the information they shared that we can better understand the current healthcare landscape of the United States.

Innovista Health Solutions thought leaders reviewed the study to provide even further analysis of the challenges associated with making the move over to value-based payment models, changing expectations regarding the site of care, and consumer engagement.


Change IS hard. The rapid changes we have seen in the healthcare industry in the past few years have been significant and far-reaching. Shifts in care settings, the adoption of value-based payment, and changes in patient expectations of how care should be delivered have posed significant challenges to even the largest, most innovative health systems. These challenges have slowed the pace of innovation in many organizations and many anticipated improvements in the quality of care and cost efficiency of delivery have taken longer to materialize than previously anticipated.

Maintaining quality while reducing the overall cost of care is a theme for almost every healthcare organization in the country. While many organizations have implemented programs aimed at achieving this goal, there are external factors that still hinder the success of such programs. These barriers are primarily related to the predominance of fee-for-service reimbursement perpetuating organizational inertia as well as the often-bewildering requirements and compliance standards of most value-based payment contracts. Add to that the potential financial risk and regulatory requirements and it is easy to see why the adoption of value and risk can be limited.

In response to these barriers, some organizations have opted to shift their focus and investment to other healthcare innovation opportunities such as increasing consumer engagement through technology platforms. While these organizations are smart to address the growing consumer demand for more a more interactive healthcare experience, we believe value-based reimbursement anchored to patient-centered care models should continue to be a primary area of focus.

The Centers for Medicare and Medicaid Services (CMS) administration has seen the potential of value-based care and is pushing for core standards of improving health outcomes and reducing waste as opposed to simply focusing on volume. Programs such as the Medicare Shared Savings Program (MSSP) specifically encourage healthcare providers to focus on patient outcomes and the implementation of high-quality, highly efficient services.

Innovista is committed to the value-based model and believes strongly in its driving principals – that health systems should be working towards providing care that is more targeted, more tailored, and more cost-effective than what we had yesterday. Innovista enables provider groups to drive this change by aligning value-based care models around the primary care physician and offering standardized, best-practice programs and platforms for physicians to succeed.

Innovista and our partner ACOs have seen significant success in cost reduction in all lines of business, but particularly in the Medicare Shared Savings Program. In performance year 2018, Innovista partner ACO’s achieved savings of over $550 per member per year more than the market average. To read more about our success in MSSP, click here.

 

About Innovista Health Solutions

Innovista Health Solutions is a population health management company that offers management and support services to guide independent physician networks, medical groups, and health systems through the ever-changing landscape of value-based care. With services and toolsets including network development, population health management, delegated services, data reporting, and strategic capital investments, Innovista is structured to help its clients succeed in their Commercial, Medicare, and Medicaid value programs. Innovista is a single resource for physician integrated models to gain access to innovative technology, expert programs, actionable data insights, financial resources, and growth opportunities, to navigate and succeed in value-based and/or risk-based contracts.

 

Innovista Media Contact

Laura Bingham

lbingham@innovista-health.com