Value-based care — the focus on quality over cost — is in full swing. Part of this concept is assuming financial risk with other providers and payers for patients’ care. Given their expertise, home care providers have a unique role to play in this model, Katy Lanz, founder and principal of consulting firm TopSight Partners, told McKnight’s Home Care in a Newsmakers podcast. And given the government’s pressure on providers to move to value-based care, participating in value-based care arrangements is becoming a smart and strategic business move, she said.
The government’s thinking toward value-based care has evolved in recent years thanks to innovative partnerships between healthcare stakeholders and payers, Katy Lanz said. Thanks to healthcare entities successfully assuming risk for seriously ill populations, the Center for Medicare and Medicaid Innovation (CMMI) has taken the stance that it wants to continue to drive value-based partnerships, said Lanz, former chief clinical officer of Aspire Health. CMMI models such as the Value-Based Insurance Design (VBID) Model and Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model are examples of this. The models, which involve providers assuming risk, have proven to save money and avoid unwanted, unnecessary hospitalizations and care. Traditional home care firms would be wise to initiate “strategic refreshes” and find opportunities to partner with at-risk providers. Lanz, who advises healthcare organizations on growth and innovation, talked about one of her large-scale clients, Dollar General. The retailer is interested in value-based care because it is concerned about its female shoppers not being able to afford or access healthcare. Also, during the podcast, Lanz clarified that when she talked recently about providers having to “show me the money,” she was talking about sharing in upside and downside risk, not receiving money for referrals.
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