Throughout every corner of the health care system, COVID-19 has ushered in a new era of collaboration and partnerships. Stakeholders have set aside competitive differences to leverage each other’s resources to ensure patients, COVID or otherwise, are being treated as effectively and efficiently as possible in this crisis.
“We found that when there’s a stark emergency like COVID, hospitals are willing to come together and collaborate. They really just appreciate taking the time to get together on the phone and listen to what everyone else is experiencing,” says Kate Schellinger, Interim Executive Director of the Illinois Medical District. “I think the fact they all had shared goals really helped them come together and collaborate, rather than be competitors.”
During the height of the COVID pandemic, both in March and April of 2020 and later during the second surge in the winter of 2020-21, the Illinois Medical District, a unit of local government whose membership includes major health care providers and organizations within and around Chicago, convened these stakeholders in twice-weekly calls to discuss the challenges they were all facing. The shared goals that Schellinger was referring to were pretty simple: “They wanted to prevent severe illness and death.”
That kind of goal is pretty straightforward, even if it can be difficult to achieve.
But can health care organizations continue the collaboration momentum in achieving a different kind of shared goal—perhaps the largest shift, rivaled only by digital transformation, the industry is currently facing other than pandemic response—moving the health care system to value-based models of care?
Partnering to address a fragmented and siloed system
The impetus for value-based care partnerships may not be as sudden and immediate as preventing COVID-related illnesses, but it’s incredibly important in changing the industry paradigm.
The transition to value-based care, in fact, was well underway in various stages long before COVID-19 and, if anything, the pandemic has demonstrated weaknesses in traditional fee for service payment models dependant on patient volumes that have highlighted the potential of alternative care models.
“Very little care is delivered in a hospital and the emergency department. An even smaller amount is delivered in academic medical centers. It’s an expensive part of the care delivery system, but it’s small part of where people actually get their care. By working together, we can change that paradigm of expensive care,” says James Dom Dera, MD, Family Medicine Physician and Patient-Centered Medical Home Medical Director for NewHealth Collaborative, Summa Health during a recent American Hospital Association webinar. “Right now, the system is fragmented and siloed. We’re paying for episodes of care. What we need to do is partner and work together in a value-based arrangement.”
Partnerships key to effective value-based models
Collaboration in value-based care doesn’t have to overly complicated, says Dom Dera. Reducing ED visits and length of stay often comes down to a health system working directly with a patient’s primary care provider or a care navigator. In some cases, he says that connecting patients with primary care providers can reduce readmissions by 25 percent.
Read more: The switch to value-based care is driving unique partnerships
In an effective value-based model, there are also multiple touchpoints for patients, with technology platforms and specialty care providers, rather than relying on a handful of in-person visits throughout the year. Summa Health relies on some of these resources from its ACO, NewHealth Collaborative, to provide many of these services for its patients. In return, the ACO gets improved outcomes and lower costs.
“When it’s done well, the ACO is a powerful tool and it’s done well by working together,” said Dom Dera. “Primary care is being disrupted by companies with ACO approaches and they are being funded by venture capitalists, private equity, health plans and in some cases, health systems. They are funding these larger ACO approaches where everyone works together to drive value.”
Quil Health CEO Carina Edwards is a big advocate for the power of collaboration when it comes to health care’s shift towards value. The company she leads, which offers a consumer engagement platform for payers and providers in population health arrangements, was the brainchild of a collaboration between NBC/Comcast and Independence Blue Cross.
The company has partnered with Penn Medicine to reduce readmissions, length of stay and increase discharge rates to the home rather than skilled nursing facilities. Success in these arrangements comes down to leveraging the strengths of the various entities involved, says Edwards.
