The Exec: BayCare Health System Names CMO to Lead Value-Based Care

This new executive has prior experience leading the accountable care organization at Memorial Hermann Health System.

BayCare Health System has named a new executive to lead value-based care efforts at the Clearwater, Florida-based health system.

Kriel Ramcharitar, MD, MPH, became vice president and CMO for value-based care at BayCare effective May 19. Prior to joining BayCare, he served as a faculty member with the Jefferson College of Public Health at Thomas Jefferson University in Philadelphia. Ramcharitar's leadership experience in value-based care includes serving as vice president and CMO of Memorial Hermann Health System's Accountable Care Organization and Population Health Service Organization.

A health system must have the right structure and infrastructure to support value-based care, according to Ramcharitar.

"Value-based care has a rich and multidisciplinary basis, including everything from finance to operations to health management to care coordination," Ramcharitar says. "It also must link in with the enterprise strategic goals and the highest leadership level in order for it to translate and transform into true operational action."

Ramcharitar says the structure and infrastructure needed to support value-based care includes having multidisciplinary teams in areas such as care coordination, pharmacy, quality teams that help with quality gap closure, and managed care contracting to ensure that value-based care agreements have metrics that matter. In addition, Ramcharitar says that a health system must have an electronic medical record (EMR) that supports value-based care implementation and monitoring to help the health system know how it is performing on metrics in terms of cost and quality.

"The structure requires the skills of team members with multidisciplinary expertise, including physicians, care coordinators, social workers, and pharmacists," Ramcharitar says. "That informs the structure to effectively deliver value-based care and to have favorable outcomes, both for quality and total cost of care across populations and communities."

Kriel Ramcharitar, MD, MPH, is vice president and CMO for value-based care at BayCare Health System. Photo courtesy of BayCare Health System.

Keys to success in running effective ACOs

There are several factors involved in operating a successful ACO, according to Ramcharitar.

"You need effective care coordination that is proportionate to the needs of your communities and populations," Ramcharitar says. "You need an evidence-based approach to pharmacy, including medication adherence and comprehensive medication management."

An ACO should have teams conducting outreach for quality gap closure, Ramcharitar explains. For example, an ACO should have outreach to patients who need breast cancer and colorectal cancer screening.

An ACO needs robust data analytics and a strong electronic medical record that enables care teams to make actionable decisions on factors related to quality, Ramcharitar says.

An engaged and high-performing physician network is crucial for an ACO, according to Ramcharitar, who adds that the ACO leadership needs to be collaborative with the network both in terms of performance and understanding the challenges physicians have in value-based care and population health. This is especially true when there are different EMRs across the network.

"At the physician practice level, they may spend several hours in their EMRs sifting through population health data," Ramcharitar says. "This can be a root cause of physician distress. So, you need to talk with your physician partners to understand the challenges they are having in terms of being able to get data and focus on population needs."

Another factor in ACO performance can be employer-based education, Ramcharitar explains.

"Often within an ACO, you have cohorts and sub-populations that are based on employer contracts," Ramcharitar says. "You need to enable employers to understand all of the services that come with being part of the ACO, so they can effectively access and manage high quality in-network services."

Succeeding in population health

At the most basic level, population health involves providing care to communities and looking at the distribution of outcomes within communities, according to Ramcharitar.

"Population health is about understanding a population," Ramcharitar says. "For example, you need to know the prevalence of type 2 diabetes, chronic obstructive pulmonary disease, and other chronic diseases within a population."

Succeeding in population health involves a strong collaborative approach with primary care, according to Ramcharitar.

"You need to have a strong primary care infrastructure to support population health," Ramcharitar says. "For example, with quality gap closure, you need to improve on annual wellness visits across the population."

Preventative care is an effective population health management strategy, Ramcharitar explains.

"For example, you need to look at cancer screening programs," Ramcharitar says. "We know at the population level that the single most effective thing that we can do to prevent premature morbidity and mortality from cancer is screening."

At a practical level, health systems must consider how population health delivery models are linked to effective reimbursement models, according to Ramcharitar.

"Population health is the delivery of effective healthcare services at the population level, but they have to be linked to the right value-based care agreements with payer partners," Ramcharitar says.