As of Tuesday, January 8, 2019
Explaining value-based care
The Blue Cross of Idaho web site states it’s testing more affordable healthcare options by testing a new healthcare provider payment model in Idaho.
“We have been working with healthcare providers throughout the state to transition from a fee-for-service system that pays them for the amount of services they provide, to one that rewards them for the healthcare results they achieve.”
Blue Cross states “value-based care improves outcomes while lowering costs.”
In value-based care; providers are incentivized to coordinate care with other providers; minimize unnecessary tests or procedures; seek alternative evidence-based, lower-cost care; and investigate cost trends and best practices.
Healthcare providers who deliver above average care at below average cost receive higher compensation rather than those who perform below average.
For further details, see the article “Lower costs with value-based care” on-line at https://stayinformed.bcidaho.com/article.page?id=jk48pq3y.
GRANGEVILLE The Syringa Hospital Board meeting Dec. 18, 2018, had nearly its entire focus on “value-based care.”
Value-based care is defined as a payment model that rewards healthcare providers for providing quality care to patients by focusing on collaboration and keeping care more affordable through a variety of tasks.
The discussion revolved partially around a decision to enter into a collaboration / testing / pilot program with Blue Cross at a cost of $40,000.
“This is a major direction and it’s a decision by the hospital leadership team?” trustee Jim May questioned the board’s involvement. “I feel it’s something we [the board] should be actively involved in.”
“We’ve been on this road for four years,” said trustee Steve Didier. “I feel we’ve been informed and have looked at value-based options several times. Beyond that, the CEO can enter into contracts without us looking over his shoulder.”
“I agree with Jim – it’s a big issue and this decision seems quick,” trustee Jan Carlson said.
Board chair Leta Strauss emphasized the issue had been discussed at length during strategic planning sessions and committee meetings.
“If we do not get involved and figure things out ourselves, we will eventually be forced – that’s the way it’s headed and had been headed for quite a while,” she said.
May said his concern was not whether or not to do it, but how much the board should be involved.
“I wouldn’t want to be tasked with every operational decision,” commented vice chair Jerry Zumalt.
CEO Abner King said all Blue Cross contracts are up in 2020, so the issue would have to be addressed by then.
“This [timing] will give us some perspective before that time,” he said.
“Then there’s a year’s opportunity to see if what we are thinking and doing is working,” Didier added.
“I’m not trying to pick a fight in this, but to me it’s a sudden, dramatic change,” May said.
Strauss said a task force had had time to chew on the ideas, so some may be “a little more down the road than other.”
“There has to a be a certain level of trust between all of us – it’s good to talk and build this trust,” Strauss emphasized.
“Yes, it’s definitely appropriate to discuss,” Zumalt added.
The board looked at a variety of areas under value-based care readiness, including governance and leadership, care management, clinical care, community health, patient and family engagement, performance improvement, health information technology and financial risk management. Research in these and other areas will be used as strategic planning tools for value-based care action planning.
In other news, the board voted unanimously to extend by three years its hospital management services agreement with Kootenai Health.
The next meeting is set for Tuesday, Jan. 22, 12:30 p.m., Soltman Center, and will include the 2018 audit report.