Every month we have a focus on one of our Implementation Partners; this program was set up to support providers in establishing ICHOM Sets within daily clinical practice, and our network offers support in technical, change management, costing and resource planning.
This month we hear from Point B’s Sicely Donaldson, Executive Vice President, Health & Life Sciences about the importance of trust in healthcare, trends they think will shape the evolution of the sector over the next ten years, and how patient outcomes need to be at the center of sustainable models of care.
Q: Can you give us a brief introduction to Point B, and what you do?
Point B is a leading US-based consulting firm recognized by Modern Healthcare as one of the top twenty US-based healthcare consulting firms year-over-year. Our first customer over twenty-five years ago was a healthcare provider who is still a customer today. Today, we work with providers, payers, and life sciences clients worldwide.
Point B’s decades of experience partnering with organizations to advance health across the industry allows us to bring fresh perspectives that accelerate our customer’s missions to improve outcomes, deliver more value, and create a healthier world.
Q: What is Point B’s expertise in helping clients with Value-Based Care?
In value-based care transformation, our expertise is operationalizing strategy and achieving outcomes through our integrated approach to data and analytics, operational excellence, and change management. Our human-centered approach facilitates organizational and stakeholder alignment and accelerates achieving outcome-based care objectives.
Q: What do you see as the biggest challenges – and opportunities – in expanding the network of healthcare providers using VBHC models?
The US Healthcare system is incredibly fractured. Misaligned incentives, bureaucracy, and the lack of true interoperability are all massive barriers to transformational and rapid change.
Regardless of what part of the healthcare ecosystem you live in, we know that improving patient outcomes and the patient experience is what matters most. That is where we see such great value in VBC, particularly in the patient-centered order sets from ICHOM.
Q: What message do you have for our different audiences (e.g., providers, regulators, payers, patient organizations etc.) about how they can support the transformation to an outcomes-based healthcare system?
We encourage providers, regulators, payers, and patient organizations to keep the patient at the center of everything they do and continue to utilize patient-reported outcomes. We foresee, at least in the United States, consumer choice becoming an even larger driver of success for players throughout all healthcare industry sectors. Organizations that can tie their services to successful outcomes aligned with patients’ needs and preferences will be market leaders.
Q: Can you share any examples where you’ve helped clients successfully adopted VBHC models?
A few examples include:
An ACO wanted to form a risk-based entity. We helped define the operating model including governance and program structure. The ACO was able to successfully pursue risk-based contracts with employers, payers, and the government.
We helped a community health provider reorganize their clinical programming model with primary care, pediatrics, dental, pharmacy, behavioral health, and community partnerships. We also helped them design a campus for expanded capacity.
A consortium of 25 entities wanted to develop value-based care and compensation models. We designed, piloted, and tested solutions, including data measures and governance. Our pilot yielded evidence-based results and encouraged the member companies to scale the solution.
We implemented a new technology platform for a large health plan client that enabled them to align payments with quality health outcomes across several markets and benefit programs. The solution included a new data architecture and end-user operational processes.
We helped a large health plan client align payments to quality health outcomes by implementing a new technology platform with a new data architecture and end-user operational processes across several markets and benefit programs.
Q: One of the themes of this year’s Conference is “Trust”. You’ve said that you aspire to be “the most trusted partner in the industry” but how can healthcare providers earn the trust of patients – and wider stakeholders like payers, or governments?
With patients: Be truly patient-centric. Involve patients in all decision-making. Make all decisions based on the value that it brings to a patient’s outcomes, experience, and quality of life.
With all stakeholders: Advocate for the consumer, and the patient, in all you do. Be transparent with all stakeholders with data and information – from cost to quality outcomes – other than protected data, healthcare should be an open book.
Q: Now, crystal ball time: how do you think the healthcare part of your business will look ten years from now – and what role will VBHC models play within it?
COVID accelerated several transformational elements in healthcare and moved them from pilots to widespread implementation. Over the next ten years, they will transform the way care is delivered. Namely:
- Consumer-driven healthcare – Consumers drive their own decisions about healthcare, whereas patients are passive recipients. The focus on consumers in the driver’s seat will continue to accelerate and push the industry from making decisions for patients to meeting them when and where they want care.
- Omnichannel care – Digital health became a necessity during the pandemic, and consumers demand that it continues to improve to expand health access. Healthcare delivery through the channel desired – be it in their home, digitally, local pharmacy, or traditional care site – will continue to expand and drive the necessity of interoperability, integrated health records and holistic consumer health.
- Payers, providers, and life sciences continue to integrate and align on one primary customer, the patient, the consumer. Traditionally serving multiple customers, these industries are beginning to collapse because of the shared focus on consumer health. This creates an opportunity for traditionally fractured healthcare to transform, and for new entrants to disrupt.
Value-based healthcare is an enabler of transformation. Moving from symptom management and fee-for-service to what consumers want – to attain and maintain health – requires a shift to value-based care.
