AHA Report and Presentation on Value-Based Business Models

Executives of hospitals and health systems need an effective strategy when moving from volume-based to value-based business models. To help you develop the right strategy for your organization, the American Hospital Association (AHA) has published an informative 40-page report (link below). In the report, five strategic approaches to transformation are described along with ten “guiding questions” to consider.

Last week at the AHA’s annual meeting in Washington DC, a key presentation featured panelists who discussed their different approaches to implementing value-based models. Executives from WellPoint, Billings Clinic, and Presbyterian Healthcare Services in New Mexico shared their strategies.

The three facets of the presentation showed how each organization took a different path to success: CareMore, a division within WellPoint, developed greater specialization in a market niche; Glendive Medical Center, a previously independent facility in Montana, chose to affiliate with Billings; and Presbyterian of New Mexico redefined its operations by starting a health plan that covers 435,000 members and includes 600 healthcare providers.

Jason Barker, President at CareMore, discussed solidifying its position in a niche market by focusing entirely on caring for patients who are older and frailer. Their keys to success involved accuracy in predictive modeling and earlier interventions with patients.

Scott Duke, VP of regional operations at Billings and former CEO of Glendive, talked about affiliations and emphasized several key factors when evaluating a partnership: alignment of missions, values and care models; strategic planning that involves extensive research; and consistent communications with stakeholders.

Jim Hinton, President and CEO of Presbyterian Healthcare Services, cited several critical success factors for health systems and care coordination programs: effective collaboration among all entities; aligned financial incentives; rapid cycle improvements; and clinical leadership.

You can access the AHA report on moving toward value-based models in the “Resources” section at: http://www.aha.org/research/cor/paths/index.shtml