The Mayo Clinic Health Policy Center and Health Affairs hosted a national symposium Achieving the Vision: Advancing High-Value Health Care December 5-7, 2010. The second panel discussion focused on achieving value in health care delivery.
Moderator:
Susan Dentzer, Heath Affairs
Panelists:
Mike Critelli, Dossia
Don Fisher, Ph.D., American Medical Group Association (AMGA)
Randall Krakauer, M.D., Aetna
Robert Smoldt, Arizona State University Healthcare Delivery and Policy Program
Doug Wood, M.D., Mayo Clinic
Susan Dentzer, Health Affairs, and a diverse panel representing providers, employers, payers and academia discussed ways in which the private sector and the CMS Innovation Center (CMMI) can improve care outcomes and reduce costs in a variety of health care settings.
Drawing upon his previous experience with worksite clinical care programs as CEO of Pitney Bowes, Mike Critelli suggested three elements that create higher-value health care: convenient care locations (i.e. workplaces and schools); clinically competent, empathetic caregivers; and a business model that allows providers to spend adequate time with the patient.
Randall Krakauer, M.D., Aetna, stressed that teamwork, collaboration and integration change the nature of stakeholder relationships and can significantly increase value. He cited higher-quality, lower-cost results using a chronic care management model with Aetna’s Medicare Advantage population. “When we collaborate with provider groups, our results are dramatically better than when we do it by ourselves,” he said.
Don Fisher, Ph.D., AMGA, said that care delivered to Medicare and Medicaid beneficiaries often is episodic and fragmented. He suggested that the CMMI fund initiatives that move disaggregated providers into organized systems of accountable care. Dr. Fisher stressed that new payment models must support integrated care. “Until we change the incentives,” he said, “we won’t get there. It’s all about the money.”
Robert Smoldt, ASU, noted that the current payment system doesn’t reward providers who deliver higher-quality, lower-cost care, and proposed that private payers and providers work more closely together to redesign care and find simpler solutions that benefit all stakeholders. Doug Wood, M.D., Mayo Clinic, emphasized the importance of reducing the costs of health care to patients, doctors and hospitals, and ultimately government. The best way to accomplish this, he said, is to move away from fee-for-service payment and advocating for bipartisan support for strengthening efforts to pay for value.
Dentzer then asked participants to submit recommendations that address how the CMMI and the private sector can promote innovation that will enable beneficiaries to get the highest value in their health care. The top ranked items included:
• Accelerate payment reform to support changes in health care delivery.
• Incent interoperability of health care IT systems.
• Set the standards within which we can all share data.
• Develop a practical national definition of value that is acceptable to patients, care providers and payers.
• Focus on patients with multiple co-morbidities.
Below you will find video of three of the panelists value in health care delivery:
Mike Critelli, Dossia:
Don Fisher, Ph.D., American Medical Group Association
Randall Krakauer, M.D., Aetna:
