The roundtable panelists detail their organizations' COVID-19 surge experiences, and share their thoughts about reimbursement models moving forward, and the future relationship between payers and providers.
Editor's note: This article is based on a roundtable discussion report sponsored by Optum. The full report, Vision and Change for a Better Healthcare System is available as a free download.
The COVID-19 pandemic has created obstacles that have shifted the industry's focus to what a better healthcare system could look like and what leaders should resolve to do differently.
"As a result of our COVID experience, we are thinking differently about how we value and leverage system infrastructure," said Marna Borgstrom, MPH, CEO of Yale New Haven Health System in New Haven, Connecticut. "We learned, in crisis mode, that the individuality of local delivery networks was secondary to doing what we needed to do consistently and efficiently using system resources."
For healthcare organizations, finding solutions for margin pressures and declining reimbursement means keeping a careful eye on the short term while planning for the future and seeking sources of capital for growth. The push for value-based care contracts will increase in the future.
"I see five years from now a larger proportion of our reimbursement coming from value reimbursement," said Scott Hayworth, MD, FACOG, president and CEO of CareMount Medical in Chappaqua, New York. "The physician group or the health system that is not investing heavily in preparing for value is going to have a challenge in the future as the reimbursement landscape changes."
"Each of us are at a different phase of getting there," said Sunny Bhatia, MD, CEO of Region I and corporate CMO of Prime Healthcare in Ontario, California. "Adoption of a value-based model in healthcare requires alignment and engagement from all stakeholders, providers, payers, industry, and patients. To get there, we all must come to the table and have those challenging discussions."
Proactive dialogue among stakeholders will be necessary to navigate the relationship between payers and providers.
"The hopeful and optimistic side of me wants to say that five years from now there's going to be this more magical Shangri-La relationship, but the reality is … there are going to be points of major tension, and unfortunately, some of those points could increase in the future," said Pat Basu, MD, MBA, president and CEO of Cancer Treatment Centers of America in Boca Raton, Florida.
There will be greater focus on supply chain efficiencies, telehealth utilization, resource management, infrastructure planning, and partnership models.
"How do we want to reinvent healthcare that focuses our resources, our talent, and what we can do from a future technological standpoint to ensure that we have the right outcomes at the right time at the right location?" said David Parker, president of ProMedica Senior Care in Toledo, Ohio. "…We've got to be willing to do things differently and not always do things because that's the way we've always done them."
View the complete HealthLeaders Roundtable report: Vision and Change for a Better Healthcare System
Melanie Blackman is a contributing editor for strategy, marketing, and human resources at HealthLeaders, an HCPro brand.