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Analysis

New Kindred Healthcare CMO Wants to Bridge the Payer-Provider Gap

By Christopher Cheney  
   September 11, 2019

The new chief medical officer at Kindred Healthcare, with a background in emergency medicine and health plan management, is focused on payer-provider relations and managing costs of care.

Kim Perry, DO, would like to "close the gap" in understanding about the roles of long-term acute care hospitals and inpatient rehabilitation facilities, and bring payers and providers closer together.

Perry is the new senior vice president and chief medical officer of Louisville, Kentucky-based Kindred Healthcare, LLC. Kindred, which has annual revenue of about $3.3 billion, has more than 34,000 employees in 46 states at facilities including 71 long-term acute care hospitals and 22 inpatient rehabilitation hospitals.

Most recently, Perry served for three years as a multistate chief medical officer at UnitedHealthcare, where her responsibilities included initiatives related to clinical affordability, quality of care, population health, and growth. Prior to joining UnitedHealthcare, she worked for nearly a decade at St. Louis-based BJC Healthcare, where her leadership roles included chief of emergency medicine.

Perry received her osteopathic medicine doctorate from A.T. Still University's Kirksville College of Osteopathic Medicine in Kirksville, Missouri.

HealthLeaders spoke with Perry recently to get her perspectives on issues ranging from payer-provider relations to managing costs of care. Following is a lightly edited transcript of that conversation.

HL: Why did you pick emergency medicine as your specialty?

Perry: I like diversity. I like to do different things. When I considered going into emergency medicine, I was drawn by the procedures. I am very hands-on and procedure-driven. I like the challenge of complex patients, and always liked the challenge of not knowing who was coming in.

I wasn't as interested in spending day after day with the same patient because it made me get emotionally attached to patients. In emergency medicine, patients are short term, so emotions are not overwhelming, but you get challenging patients to take care of.

I also like to partner with teams—care management teams and other physicians. I don't like to be a solo person. I like to collaborate with a lot of other people, and emergency medicine offers that.

HL: How will your background in emergency medicine and health plan management help you as the new CMO at Kindred?

Perry: In addition to emergency medicine, I have done a lot of things. I have been a chief of emergency medicine. I have been a dean of clinical education. I have been in managed care organizations, where I got to know several of the issues that providers were having. As the chief medical officer at UnitedHealthcare over the past three years, my role was to develop relationships with providers and hospitals. The managed care background is going to be particularly helpful at Kindred.

HL: Why is your managed care background valuable in your new role at Kindred?

Perry: Kindred was wise to seek a chief medical officer with managed care experience. Managed care is growing—it's definitely in the Medicare and Medicaid realms but also in the commercial realm with accountable care organizations. We're basically moving from fee-for-service to value. Under value-based care, you can't just provide services—you have to provide care well and meet quality measures and meet evidence-based measures. Having the knowledge of what that means to the payer is helpful to the provider. Kindred is a provider and I have insight into what the payers are looking for in a partnership and what value means to them. I'm trying to bring them closer together.

HL: Payers and providers have historically had an adversarial relationship. How do you bridge the gap between payers and providers?

Perry: We need to work with the payers and show what Kindred can do for health plan members. With our patients, we often focus on the total cost of care and chronic disease management. At Kindred, we take care of medically complex patients on a day-to-day basis.

It may be a little more expensive upfront than having a patient stay in a short-term acute care facility, but our focus is total cost of care. So, within 30 days, within 90 days, or within a year, we provide care to keep health plan members healthier and reduce total cost of care.

We get patients functionally and medically stable enough to be successful at home. And we help with chronic condition management—we get patients to the point where they can be independent or be at a lower level of care. We also make sure patients are strong enough that they do not have a fall or any other incident in the first year of care that could cause them to have to go to a higher level of care or have an expensive intervention. So, we just don't take care of an episode of care and let the patient go. They become part of our family, and we keep an eye on them for years.

HL: What are your top goals as CMO at Kindred?

Perry: I have two major goals that I am focused on currently.

First is to improve relationships such as relationships in our patient experience—we want patients to have the best possible experience they can have given the situation. I want to collaborate better with providers—not only hospital providers but also primary care physicians, accountable care organizations, and anyone else who touches patients, so we can work collaboratively with the patients and their lifelong journey. It's not just the episode of care—we used to get paid to provide services, but it's not like that anymore. We have to provide care well, and we have to prove to our patients and our providers that we offer the best services for complex patients.

I also want to improve relationships with the payers. They are more focused now on value and the total cost of care, and we're here to help solve some of those issues for them. We can also help with the more mundane things—care gap closures, making sure women get their mammograms, and other things that complex patients may not follow through and do.

My second goal is to develop a value story for Kindred, both on the rehab side and the long-term hospital side. I want to make sure that people understand what we do, why we do it, and the difference between an acute hospital stay and a long-term acute care facility.

HL: What are the key factors in developing relationships between acute care hospitals and postacute care facilities?

Perry: There are four keys: trust, communication, respect, and mutual understanding of what each of us do. There are still many people in healthcare, including physicians in short-term care hospitals, who do not understand what a long-term acute care hospital or an inpatient rehab facility does, and how they can benefit patients. I want to close that gap.

A big job for me is to educate, communicate, and develop these relationships so that we can get the trust, respect, and understanding to work more collaboratively. All of us—the payers and the providers—want to do the right thing for the patient while being sustainable and reducing the total cost of care. We have to collaborate more, and we have to share data more, and we can only do that when we have trust, communication, respect, and understanding.

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.


KEY TAKEAWAYS

Kindred Healthcare's new CMO, Kim Perry, DO, says the organization was wise to seek a chief medical officer with managed care experience because managed care is growing. 

Long-term acute care hospitals and inpatient rehab facilities can appeal to payers by reducing total cost of care and focusing on chronic disease management.

The key factors in fostering relationships between acute care hospitals and postacute care facilities are trust, communication, respect, and mutual understanding of care roles, Perry says.

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