What Physicians Were Thinking About at AAFP

Attending the American Academy of Family Physicians’ conference in Orlando last month, I jotted down some of my thoughts about conversations I had with PCPs about the transition to value-based care models.

The top three things I heard:

  1. How can I make money and sustain my practice with value-based care? In value-based payment models, quality metrics (made up of HEDIS and Stars measures) determine how PCPs are paid. Payers can help in a couple of important ways – by simplifying how you identify the metrics (so you can maximize your pay) and by simplifying how you track metrics (so you get credit for all the good work you do and the results you achieve). Also, payers can share data and analytics with you so you can more effectively provide proactive and preventive care.
  2. How can I be responsible for my patients’ health outcomes when some patients don’t follow my recommendations? We all know that not all patients do what we say, but there are resources outside the traditional clinical care setting that physicians can use to increase the likelihood of patient engagement. That’s where the payer you chose to enter into a value-based care relationship becomes so important – because of the extended resources it can provide you. For example, Humana has introduced physicians to new partners that address a multitude of barriers to their patients’ health, from access to food and medicine to transportation and home care needs.
  3. How can a payer help me improve population health, given the massive pressure to reduce costs? Cost reduction will never be achieved at the expense of high-quality care and improved population health. When people are healthy, they spend less time in the hospital. So, the PCP-payer relationship is moving away from – dare I say – being adversarial, to a model that’s more like this: Physicians help patients get healthier; the healthier their patients, the more physicians are financially reimbursed. Healthier patients mean lower costs for payers. More and more, PCPs are relying on the data payers give them about their patients, and payers are relying on PCPs to use the data to improve their patient’s health.

Feel free to share what’s on your mind. Email my office at ocmo@humana.com.

Roy Beveridge, M.D. Senior Vice President and Chief Medical Officer