Health system C-suites eye value-based care roles

Healthcare is in flux. Hospitals across the nation report clinician shortages and tight margins, and insurers are pushing more care into the lower cost settings.

Forward-looking hospital leaders are feeling the pinch and getting serious about value-based care, which means promoting leaders who can embrace this value transition and innovate for the future.

"I anticipate a dedicated set of roles and skills to help navigate the path from fee for service and volume to value-heavy agreements [will be essential]," David Rottinghaus, MD, president of the physician network at Butler (Pa.) Health System, told Becker's. "We will need to make sure there is a steady flow of revenue to sustain health system operations, while directing resources toward quality arrangements with payers."

But the transition is easier said than done, especially because it can take months for health systems to realize the benefits of hitting quality metrics.

"High quality care and outcomes, coupled with waste reduction and cost-control, need to be appropriately supported by payers and to the benefit of patients and overall sustainability of healthcare," said Dr. Rottinghaus.

Outside forces are also accelerating the shift to value-based care. As more patients become responsible for a larger portion of their medical bills, they're looking for the most cost-effective options that provide the best experience, which means easy access to care.

"Healthcare today is shaped by various disruptors, including telemedicine, artificial intelligence, value-based care and data-driven decision-making," Liz Popwell, chief strategy and transformation officer at Stony Brook (N.Y.) Medicine. "Leaders who can navigate these disruptions and drive transformation are essential to this evolving landscape."

Stony Brook Medicine has taken big strategic steps for digital transformation and delivering value-based care. Leaders who are focused on innovation, improving quality and access while also understanding predictive analytics will thrive, Ms. Popwell said. She sees the most effective leaders being visionary thinkers, strong communicators and adept at collaboration and building trust.

Organizations that stick to the traditional fee-for-service model could be left behind.

Bob Sarkar, president and CEO of Arkansas Health Network in Little Rock, part of CommonSpirit Health, told Becker's it's important for leaders to be "multifaceted in their skill sets in both fee for service and fee for value sectors."

"The everyday challenges of healthcare leadership are currently being amplified by the paradigm shift we're seeing in the industry," Mr. Sarkar said. "There's a growing discrepancy between reimbursement rates and the actual costs incurred, as well as the necessary investments in our communities that are needed for us to continue providing the highest quality of care to our patients."

He noted Arkansas is at the lower end of the scale for reimbursement rates for both private and government payers, according to a January 2022 report to Congress. Mr. Sarkar said authentic and adaptive leaders must also be empathetic and resilient to effectively lead their teams. It can also be easy to feel fatigue in the current financial landscape, and leaders who connect their teams with the health system's mission can avoid it.

"In today's rapidly evolving healthcare landscape, the types of leaders that are quickly becoming the most essential to organizations are those who possess a strong blend of strategic vision, adaptability, and a deep understanding of the technical advancements," said Ebrahim Barkoudah, MD, system chief and regional chief medical officer at Baystate Health in Springfield, Mass. "Healthcare leaders who can navigate the complexities of value-based care, leverage data analytics for informed decision-making, and foster a culture of innovation are increasingly vital."

Healthcare in the rural U.S. is no different. Ben Bucher, CEO of Towner County Medical Center in Cando, N.D., told Becker's the most essential skills for tomorrow's healthcare leaders will be managing population health and supporting value-based care initiatives.

"Coming from a rural background, executive teams and governing boards need to find a way to collaborate with other healthcare providers and organizations to improve patient quality, create healthier communities, and utilize their network scale to begin to drive down the cost of healthcare and manage value-based programs," he said. "Through clinically integrated networks, interdependence drives independence and keeps decision making and healthcare local."

He said strategically bringing together physicians, payers, rural healthcare organizations and population health management leaders will be essential to accelerate value-based care in the future.

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