This week, we continue our Nashville Health Care Council Sessions series with an episode focused on the industry’s stepwise progression to value-based care (VBC). The shift to value is something that everyone across the healthcare continuum supports in principle, but achieving it is a massive economic and technological undertaking. Ingrained structural challenges have made the transition slower than hoped.Onstage at Sessions, speakers talked about how the unsustainability of our current healthcare spend is forcing the issue. That, combined with creative new models from entrepreneurs and national organizations, are helping to finally make an accelerated transition to value feasible for providers, payers, patients and every stakeholder in between.  We spoke with Dr. Wyatt Decker, Executive Vice President and Chief Physician for Value Based Care and Innovation at UnitedHealth Group, and Rob Allen, CEO of Intermountain Health, about the innovations that will be necessary to streamline VBC, as well as their respective philosophies about long-term health in a volume-based world.  

Key Points:  

VBC is only possible at scale if everyone works together. The most formidable roadblock to value is its operational complexity, requiring every stakeholder to rethink how they administer and measure the success of their services.  

The shift to value poses incredible business opportunities for entrepreneurs. From the need for better clinical data tracking to changes in risk sharing to disjointed communication between payers and providers, there is a lot of space to fill for specialized start-ups. Per Dr. Decker: “We work with entrepreneurs of all sizes in terms of their business who have solutions.” 

Achieving VBC hinges on better systems for understanding patients’ needs. Large providers and payers will rely more heavily on personal relationships with individuals to ensure the clinical understanding necessary to set and achieve health metrics.  

Data is top down and bottom up. While VBC is tailored to the individual, it can only be achieved through a clear understanding of community and population-level data. Data collection and analysis have finally reached a point where the resulting information can be used effectively to drive population health. 

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