The healthcare industry is slowly moving away from a fee-for-service model to a value-based care model. But one thing that is missing in the discussions around value-based care is how it is being measured, according to Don Antonucci, president and CEO of Providence Health Plan.
“Some people say value-based care and they’re talking about affordability only,” he said in a recent interview at the AHIP 2024 conference held in Las Vegas. “Or they’re talking a little bit about affordability and quality. But they’re missing sometimes, what does the access look like? Is it the right access in addition to the affordability and quality? Is there an experience for the actual doctors and nurses and providers? … And then how does that translate to the member or patient experience in value-based care? How does value-based care start to address health equity?”
Providence Health Plan, headquartered in Portland, Oregon, has about 660,000 members. It has plans for employers, Medicare, individuals and families and Medicaid. It is part of Providence, a non-profit healthcare system with 51 hospitals.
Antonucci added that different lines of business are moving faster than others in the transition to value-based care, like Medicare Advantage. Employer-sponsored plans, however, are moving slower, though Antonucci is hopeful this will change.
“We need to see — and I think we will — progress on the employer side because part of what employers are about to experience is continued double-digit increases in [the cost of] care, and that’s really not affordable,” he said. “Part of the solution is moving into these models. That is going to keep costs in control but also deliver on quality and the access and all the things employers are now talking about.”
What gives him a lot of optimism when it comes to value-based care is that the technology is improving to support the shift away from fee-for-service. For example, Providence Health Plan has been able to update its claims system and integrate it with its provider partners, which helps them share information and provide better care to patients.
Providence also has an app that improves care and makes it more efficient, Antonucci added. For example, when he recently went in for his own primary care visit, the doctor was able to have a face-to-face conversation with Antonucci while the information was being populated into the electronic medical record.
“It actually gives [the doctor] time back and actually helps him to engage,” Antonucci said. “But what’s really cool is I can click on that app, and then the information is now served to me. And then any follow-up appointments or things that I have are all created right there.”
Antonucci added that while “value-based care is not the silver bullet solution, it’s a huge part of where we have to move in order to address the challenges that we have in healthcare.”
Photo: atibodyphoto, Getty Images
