COVID-19 has driven millions into poverty and exacerbated the social needs of already vulnerable communities. In this session, learn about data-driven approaches to population health by exploring how these questions are answered:
- What does a resilient health infrastructure look like?
- How does data support this?
- What is the role health plans can play in “building back better” and more equitably, such that the system itself supports better health and reduced costs?
Panelists:
Senior Director, Market Intelligence, Market Analytics and Digital Products
Priority Health
Moderator:
The pandemic underscored the realization of the extent of health inequities marginalized populations, such as racial and ethnic minorities and socioeconomically vulnerable individuals, face in the US. As the country takes action to bring attention to and try to tackle these societal struggles, the health care community has begun to amass ideas and efforts to do its part. The journey from volume-to-value has offered many insights and learnings – in both successes and failures – that we can put towards these efforts. In this two-part discussion, explore new ideas, approaches, and initiatives to consider to “pay for equity” and propel these efforts forward.
- Discuss the changes and rationale needed to make an impact
- Examine lessons learned from the value-based payment movement
- Explore different approaches, such as using ‘social risk adjustment’ or ‘equity audits,’ that should be considered
Part One:
Medical Director, Payment Strategy, UW Medicine;
Member, Physician-Focused Payment Model Technical Advisory Committee, US Department of Health and Human Services
Part Two:
Panelists:
Moderator:
Value-based health care is a model for improving health outcomes in uninsured adults that can lead to reductions in uncompensated hospital care. Effective and appropriate primary care improves patient health outcomes resulting in substantial reductions in primary care preventable or avoidable hospitalizations. Baylor Scott & White Health has invested in community-based primary care medical homes (Baylor Community Care Clinics, BCC) that provide healthcare to uninsured and underinsured individuals. Clinics have an integrated team that manages patients with chronic disease including a medical doctor, nurse practitioner, pharmacist, licensed social worker, community health worker, and access to a dietician. To improve value, the BCC model is evaluated on patient outcomes, emergency department visits, hospitalizations, and associated costs. An evaluation was conducted from 2017 – 2020 in approximately 16,000 BCC patients who were primarily racial/ethnic minorities and uninsured. On average over 3 years, BCC patients had a 48% reduction in direct costs due to inpatient hospitalizations, and a 43% reduction in direct costs due to emergency department visits compared to similar patients not receiving BCC services.
- Better understand how value-based care looks for a population of underinsured and uninsured adults
- Discuss the role of community health workers in population health efforts to improve health and reduce costs
- Learn about specific population health approaches that improve chronic disease outcomes and reduce costs in high-risk populations
- Explore models of integrated care that improve value and reduce costs
Learn about a value-based, single-door approach to providing primary care for the entire community, regardless of ability to pay. It is common for communities to have Federally Qualified Health Centers or public hospitals providing care for the uninsured. Yet it is exceedingly rare to see these practices succeed in providing care to both insured and uninsured patients in the same practices. Since 2017, Memorial Primary Care has brought in millions to the bottom line of our public health care system by engaging in shared-savings contracts with payors and providing a value-based care mindset to caring for both uninsured and insured patients in the same community-based settings. Engaging providers in this process requires ongoing education as well as innovative IT solutions.
- Gain perspective to think differently about providing uncompensated care
- Focus on good clinical practice and the money will follow
- Hear specific examples of how to leverage provider-focused IT solutions to succeed in value-based primary care









