THE VALUED VOICE

Vol. 65, Issue 23
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Thursday, June 10, 2021

   

Living in Two Payer Models: Fee for Service and Value-Based Care

Fort HealthCare Senior Director of Clinical Operations Carl Selvick and Door County Medical Center CEO Brian Stephens shared their perspectives and experiences with alternative care models at the Wisconsin Hospital Association (WHA) Wisconsin Rural Health Conference.
 
Selvick started the discussion by defining an alternate care model as any model where the insurance industry attempts to shift the cost equation of value and elements of cost away from the hospital or health system. Stephens set the stage for an enlightening dialogue between the two health care leaders by explaining that many smaller rural health clinics lack experience with value-based payment models and their requirements, such as performance reporting. Many such providers face unique challenges when participating in a value-based payment model due, in part, to the geographic dispersion of their patients.
 
Selvick and Stephens stressed that when looking at value-based models, it is important to have both the clinical side and payer representatives engaged. Care management teams can help to look at social determinants of health, but this requires giving them the flexibility necessary to help move patients toward a healthy lifestyle.
 
Partnership, both speakers stressed, is critical to maximizing the health of rural patients. It is important to have relationships with community organizations such as the Aging and Disability Resource Center, home health agencies, protective services, behavioral health services and the family caregivers.

See a wrap-up of the 2021 Wisconsin Rural Health Conference in photos here.
 

This story originally appeared in the June 10, 2021 edition of WHA Newsletter

WHA Logo
Thursday, June 10, 2021

Living in Two Payer Models: Fee for Service and Value-Based Care

Fort HealthCare Senior Director of Clinical Operations Carl Selvick and Door County Medical Center CEO Brian Stephens shared their perspectives and experiences with alternative care models at the Wisconsin Hospital Association (WHA) Wisconsin Rural Health Conference.
 
Selvick started the discussion by defining an alternate care model as any model where the insurance industry attempts to shift the cost equation of value and elements of cost away from the hospital or health system. Stephens set the stage for an enlightening dialogue between the two health care leaders by explaining that many smaller rural health clinics lack experience with value-based payment models and their requirements, such as performance reporting. Many such providers face unique challenges when participating in a value-based payment model due, in part, to the geographic dispersion of their patients.
 
Selvick and Stephens stressed that when looking at value-based models, it is important to have both the clinical side and payer representatives engaged. Care management teams can help to look at social determinants of health, but this requires giving them the flexibility necessary to help move patients toward a healthy lifestyle.
 
Partnership, both speakers stressed, is critical to maximizing the health of rural patients. It is important to have relationships with community organizations such as the Aging and Disability Resource Center, home health agencies, protective services, behavioral health services and the family caregivers.

See a wrap-up of the 2021 Wisconsin Rural Health Conference in photos here.
 

This story originally appeared in the June 10, 2021 edition of WHA Newsletter