Contributor: Joe Raphael, DrPH, FACLM, MBA, MA, LMFT, CHES, HAPM
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There’s a huge disruption taking place in the healthcare industry that is impacting the clinical and corporate worlds. This disruption entails moving from a fee-for-service, volume-based healthcare delivery model to a value-based system. Healthcare providers and corporations alike are struggling with how to respond. Providers are asking how to adjust to the change, and corporations are questioning how they will benefit.
The transition from the unsustainable volume-based model of delivery to a value-based system is top of mind among organizations and their leadership. This transition has stimulated the healthcare ecosystem to ask one overarching question, “How are we going to respond?” Every organization is evaluating how their response will change their healthcare environment. Most of us agree that changing the healthcare environment will require a multi-level strategy and, like most responses to change, some are well on their way, and others are lagging behind. As your organization prepares, evaluates, or revises its response, I contend that employee health status is one innovative approach to build the heart and soul of a value-based system.
The formula to respond to value-based care is difficult to write and arguably more difficult to facilitate. I propose we start with what we know: Value-based care is about achieving excellent clinical outcomes at the lowest cost by utilizing integrative teams focused on prevention.
- Value-based care was a response to the escalating costs of chronic disease and related risk management.
- One problem many are examining is how different the value-based environment looks from the current volume-based model of delivery.
- The transition will impact most of us.
- We all have a role in responding.
What we don’t know is how best to respond. Some believe the focus should be on best practices and evidence-based outcome techniques. Others are following prescriptive orders, subscribing to overt behavioral modification or building integrative teams. Many are examining what is working, what is not working, and preparing how to move from good to great. Most have a Strength, Weakness, Opportunity, and Threat (SWOT) analysis to rival all the others. At this point, many of you are saying, Joe, nothing you are saying is new, thank you for the review. I propose what could be new is where you are focusing your attention. And that should be on the health of your employees. After all, it is your employees who contribute to and support your organization’s health and prosperity.
So how do we demonstrate a focus on human capital to build a healthcare environment in support of value-based care? Start with a health risk prevention plan centered in Lifestyle Medicine. Employees need a personalized blueprint for the teachable moment when an individual understands health risks and specific actions which can be taken to address them. A scientifically valid, evidence-based health risk assessment outlines the connection between lifestyle habits and the risk of costly, preventable conditions which negatively impact one’s quality of life.
A health risk assessment’s (HRA) primary purpose is to provide the information needed to design a personalized plan to mitigate risk and focus on preventive action. An HRA enables trending of issues known to impact the quality and cost of care. Despite this knowledge, some people and practitioners are falling back into a generalized mantra of “eat more healthfully and exercise more.” An individual’s health risks serve as a roadmap for developing a comprehensive lifestyle-targeted intervention.
Lifestyle Medicine and value-based care are grounded in evidence-based outcomes. Lifestyle practices support behaviors that impact health and aid in sharing clinical information and identifying opportunities for quality improvements. Lifestyle Medicine is about achieving excellent outcomes at lower cost by utilizing integrative teams focused on prevention. Sounds just like value-based care to me!
My challenge to leadership and decision-makers is to not lose out on employees as individuals and to build an environment that supports and can optimally benefit from value-based care.
Contact Joe at: firstname.lastname@example.org