Fusion5 CEO Jim Gera: Bundled payments are working

In this special Speaker Series, Becker's Healthcare caught up with Jim Gera, CEO of Fusion5, a company that provides technology-based management solutions to support value-based care. 

Mr. Gera will speak on a panel at Becker's Hospital Review 7th Annual CEO + CFO Roundtable titled " Key Thoughts on Data and Analytics for Value-Based Care: What Does It Take to Get the Data You Need and Get It to the Right People? What Kind of Investment Is Needed and How Do You Make Improvements?" at 11 a.m. on Tuesday, Nov. 13. Learn more about the event and register to attend in Chicago.

Question: What keeps you excited and motivated to come to work each day?

Jim Gera: There is so much to be excited about at Fusion5. To begin with, the Bundled Payments for Care Improvement Advanced model is making Medicare and commercial insurers more efficient and effective. Bundled payments, when done right, make healthcare more cost-effective while improving patient care. It allows physicians to work with patients to develop individualized care plans that take bio-social-medical needs into account. There is a lot of work and collaboration involved, but when we see a reduction in readmissions, healthier patients, and a more efficient healthcare system emerging, the hard work is well worth it.

Q: What is one of the most interesting healthcare industry changes you've observed in recent years?


JG: The shift to value-based care has been a significant change, and, in my opinion, sorely needed. We've seen a reduction in costs across the spectrum when a value-based care model is adopted. Healthcare is inherently costly. It always will be, though there are certainly initiatives that reduce costs — initiatives like bundled payments. The entire healthcare ecosystem is moving toward an emphasis on getting more value for their dollar, which in the long run will reduce the total amount of dollars patients, insurers, the government, and hospitals are spending on care.

Q: What's one conviction in healthcare that needs to be challenged?

JG: People often think the healthcare system is broken beyond repair, and we need to scrap the entire way we approach healthcare. In my opinion, that is not constructive and needs to be challenged. While it is true that the United States has some of the most expensive healthcare in the world, it is also true that we have some of the highest quality healthcare in the world. Bundled payments are an important part of helping us standardize on best practices while allowing the flexibility to address individual needs.

We believe it is possible to maintain high quality healthcare while decreasing costs through value-based care, and even specifically through bundled payments. That is why the BPCI program has received support from both the Obama and Trump administrations. It is working.

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