COPD insider

Making the shift to value-based care: Principles before processes

Don’t make the transition to value-based care without understanding these key principles to transformation. 

Share this story

In his blog post Maximizing Value-Based Care: Six keys to financial and workflow success, Mason Beard, Chief Solutions Leader for Philips Population Health Management Group and co-founder of Philips Wellcentive, acknowledges a lingering cloud of skepticism around the transition from volume- to value-based care among today’s providers.

 

COPD insider recently sat down with Beard to learn more about his insights into value-based care and how best to increase your momentum to implement it. Contrary to what many believe, this doesn’t start with organizational processes. It starts with principles, such as elevating organizational culture.

Contributor

Mason Beard

Mason Beard

Chief Solutions Leader for Philips Population Health Management Group

Co-founder of Philips Wellcentive

As healthcare reform evolves, we can’t just
change our processes, we must transform our whole way of thinking to successfully adapt to the disruption that value-based care represents.”

Mason Beard

Chief Solutions Leader for Philips Population Health Management Group

Co-founder of Philips Wellcentive

Establish a culture of value-based thinking

 

The shift to value-based care begins with a shift in mindset. Before operational change can begin, people need to understand the need for change and develop an openness to it. This is done through organizational culture and is most effective when it starts at the top with management and senior leadership.

Change does not come about with differences in functional processes alone, but by differences in culture."

Stuart Pollack, M.D.

Medical director

Brigham and Women's Advanced Primary Care Associations

According to John P. Kotter and James L. Heskett, researchers of culture and organizational performance, culture is defined as "…a gained knowledge, explanations, values, beliefs, communication, and behaviors of a large group of people at the same time and the same place." They also maintain that differences in culture can be why one company succeeds and another one fails within the same industry.1

 

Stuart Pollack, M.D., medical director at Brigham and Women's Advanced Primary Care Associations, suggests that, "Those who try to replicate the results of successful Triple Aim initiatives have the wrong focus—looking at raw processes instead of shifts in culture and principles."2

The value of shared context

 

Before teams can get engaged in your initiative, they need to know the context. The shift to value-based healthcare stems from changes in care delivery and consumer expectations. By grounding teams in the following information, you can help them get a better understanding of why your organization needs change.

Eye icon

Reinforce the vision

 

Before you can live the culture of an organization, there must be a clear and concise articulation of its vision and values. An excellent example is that of the Mayo Clinic. In an article from athenainsight about the “Mayo Way”, Stephen Swensen, M.D., Medical Director in the Office of Leadership and Organization Development, says, “I have 61,000 colleagues at Mayo and virtually every one of them would say, “I’ll tell you what our primary value is. The Primary value is that the needs of the patient come first.”

Dollar sign icon

Understand that consumerism is here to stay

 

According to the Institute of Healthcare Communication (IHC), consumerism is defined as “transforming an employer’s health benefit plan into one that puts economic purchasing power—and decision-making—in the hands of participants.”4

 

Beard goes on to explain, “We are not just treating patients anymore, we are servicing consumers. That means we must shift our thinking to create a culture that improves the patient experience, and ultimately increases patient loyalty.”

Hand icon

Remember that medicine may be an avocation, but healthcare is a business

 

Beard explains that the shift to value-based care is putting business and administrative responsibilities on providers who may not want to accept the challenge. “Accepting the business of healthcare must be part of the fundamental culture change,” he explains. “To be clinically relevant today requires that providers be financially viable. Those who are able to embrace this change are likely to see results in market share.”

Move the food bowl

Beard recalls a famous quote made by a chief medical officer who was commenting on the difficulty of change relative to value-based care. He said,  “What’s the best way to herd cats? You move the food bowl.”

 

Beard concurs that helping providers make cultural changes requires incentives to guide and reinforce behavior. He explains, “Because providers touch every aspect of healthcare, we're asking them to be cultural leaders in the transformation to value-based care. Like it or not, they are being thrust into the position of change agent.”

Building upon culture

Beard maintains that, while culture is at the heart of transformation, further opportunities are vital to explore. This refers to a series of actions, which range dramatically in scale. You don’t need to embrace them all at once, but successively, depending on where you are in the transition process.

Key actions to complement culture on the road to value-based care:

Some providers equate the shift to value-based care with turning the Titanic around in a bathtub. But with the proper resources and support, and most importantly, a change in culture and mindset, meaningful change is not only possible, it’s inevitable.”

Mason Beard

Chief Solutions Leader for Philips Population Health Management Group

Co-founder of Philips Wellcentive

Embracing value-based care

 

The shift to value-based care will take time. But, by creating a culture for change, sharing context to keep care teams engaged and operating more effectively, you can ensure that your organization is poised to succeed in the future of healthcare.

Email icon

Register now for exclusive monthly content like this delivered directly to your inbox

Contact information

* This field is mandatory
*

Contact details

*
*
*

Company details

*
*
Please Note: To receive the COPD insider newsletter the opt-in box must be selected.

Further reading

Link icon

COPD insider

  • Driving value with home NIV

    Driving value with home NIV

    You may already know the clinical benefits of home NIV, but now discover the significant cost savings this new approach could bring to your organization.

  • Why focusing solely on costs is short-sighted

    Why focusing solely on costs is short-sighted

    Listen to Christine Cunningham, RRT discuss the implications of focusing solely on cost when purchasing home-care equipment. Discover the downfalls of devices that don’t meet patient oxygen requirements and other insights into the home-care setting in this compelling video.

  • How to get your COPD initiative funded

    How to get your COPD initiative funded

    Funds are hard to come by today. Don’t miss your chance to secure the capital you need to advance value-based care.

References

1Zenger J.Forbes. Change your leaders. Change your culture. Nov 2017 https://www.forbes.com/sites/jackzenger/2017/11/25/change-your-leaders-to-change-your-culture/#6c1e880867d5. Accessed April 30, 2018.

2Pollack S. Health Affairs Blog. When health care transformation fails. April 2015. https://www.healthaffairs.org/do/10.1377/hblog20150427.047232/full/. Accessed April 30, 2018.

3Sweeney-Platt J. athenainsight. The Mayo Clinic’s culture of ‘Socialism run by Republicans’. September 2016. https://www.athenahealth.com/insight/mayo-clinic-culture-stephen-swensen. Accessed April 30, 2018.

4nrc HEALTH. What is consumerism in healthcare? April 2016 https://nrchealth.com/what-is-consumerism-in-healthcare/. Accessed April 30, 2018.

5Advanced MD. 3 tips to stop revenue leaks in your private practice. http://imaging.ubmmedica.com/all/editorial/physicianspractice/pdfs/3_tips_to_stop_revenue_leaks.pdf. Accessed May 16, 2018.

6Doc halo. The Clinical Communication Company. The Clinical Communication Quick Course: what health systems really need to learn about interoperability. On-call management and information overload. https://www.dochalo.com/wp-content/uploads/Doc-Halo-White-Paper-Physician-Alignment.pdf. Accessed May 16, 2018.

7Belveau J. RevCycle Intelligence. 31% of providers still use manual claims denial management. An HIMSS analytics survey found that less than half of providers use an automated claims denial management system, but adoption rates are expected to rise in the future. https://dochalo.usdphosting.com/resources/white-papers/physician-alighment/. Accessed May 17, 2018.

8Tohill M. RevCycyleIntelligence, 8 tips for avoiding denials, improving claims reimbursement. For many practices, reducing the denial of claims can put them on the path to improved claims reimbursement. https://revcyclinintelligence.com/news/8-tip-for-avoiding-denials-improving-claims-reimbursement. Accessed May 16, 2018.

All content on this site is for informational and educational purposes only and is not a substitute for medical advice of your doctor or other health care professional. Always seek the advice of your physician or other health care provider with any questions you may have about any medical condition.  Refer to the Terms of Use for additional information.