Q&A: COVID should accelerate push to value-based models, Allina Health and Allina Health-Aetna execs say




, Q&A: COVID should accelerate push to value-based models, Allina Health and Allina Health-Aetna execs say

For all the challenges the pandemic has posed for the trade, many executives consider there’s no less than one silver lining: a higher emphasis on the necessity to undertake new cost and care supply fashions. Dr. Penny Wheeler, president and CEO at Allina Well being, and Tom Lindquist, CEO of Allina Well being-Aetna, a three way partnership between these two organizations, spoke with Trendy Healthcare Managing Editor Matthew Weinstock about efforts to maintain value-based care and drive extra innovation. The next is an edited transcript.

MH: What are you doing to attempt to encourage sufferers to return for routine care? Tom, are you able to discuss your members, significantly seniors?

Lindquist: The senior inhabitants is nervous and for good purpose. We’ve partnered with Dr. Wheeler and Allina Well being to do some podcasts and (put out) data to verify individuals perceive how essential it’s to get in for that care. However along with that, we’re sending out comfort packages to our seniors that embody thermometers, masks, hand sanitizers and all of the issues that they might want to assist them really feel secure, if a digital go to is just not for them, to get in and search the care that they want.

Wheeler: The priority could be very actual. We’re seeing a 40% lower within the variety of people who find themselves coming in for care with stroke. I don’t suppose the stroke charge has gone down, and I heard from a colleague simply the opposite day, that had a affected person with 4 days of stomach ache who didn’t are available and had a ruptured appendix.

We’re seeing problems that we didn’t use to see earlier than. To Tom’s level, one, is assuring individuals they will get care safely. A part of it’s a concern of the unknown. (For some sufferers), our first method is by telemedicine and that’s a brand new discussion board for many individuals. A part of it’s a priority about secure practices and care, and are they in danger if they arrive in? And we fear in regards to the financial pressures on individuals—associated to the virus and past—that they’ll keep away from care due to issues about cost.

We’re making an attempt to work towards value-based cost and make issues extra reasonably priced.

However for all these causes, we firmly consider that prevented care is just not secure care and that’s a priority proper now.

MH: Should you’re seeing that with one thing as critical as stroke, how do you message to those that “It’s important to are available and get the correct care”?

Wheeler: Many organizations have been adaptive. We went from 50 digital visits a day to 4 to 5 thousand a day throughout this, however what we’re doing now past that’s being extra proactive. We’re reaching out to individuals who had a scheduled most cancers surgical procedure, however didn’t are available for it or who’ve a continual sickness and are in danger for maybe a stroke due to hypertension or one thing. So we’re reaching out to these individuals at best danger.

Lindquist: We’re doing the identical factor. We get pleasure from partnering with Allina and having not simply the real-time information, however historic data. We’re doing the identical and reaching out to those people which are in danger or rising danger and asking them to go in and see their doctor, serving to them schedule their appointment.

Wheeler: That’s the facility of the partnership too, as a result of we will’t inform essentially that a hypertensive affected person hasn’t stuffed their prescription.

MH: Trying on the speedy adoption of telehealth, what are a number of the limitations you might be seeing?

Wheeler: Not all visits (might be achieved nearly). The place you want intense bodily exams, some further lab work, some procedural work, that doesn’t work. The opposite factor that we don’t wish to occur is have deepened disparities. There are some individuals who don’t have entry to broadband in a few of our higher Minnesota areas, for instance, or in some communities. Typically the platform, itself, or entry to the platform is a barrier as effectively.

Lindquist: The entry to broadband is an issue for a few of our members and sufferers. I feel the opposite facet of that’s that the technical limitations that the payers and the suppliers are going through as effectively. There’s been an explosion, and so, as new options are coming in, we’ve got to combine these with our current techniques. Typically these techniques are just a little antiquated.

We’re coping with just a little little bit of a silver lining because it pertains to COVID as a result of we’ve seen an explosion of innovation in healthcare, which is so overdue and far wanted. With that, comes the technical challenges behind the scenes of integrating all of this into the system so that you’ve got that continuity of care, and also you don’t have gaps; a possible problem is a member or a affected person calls in for a televisit, nevertheless it’s not linked to something.

And so that you doubtlessly lose that continuity of care. All of those are our points that we’re working with our personal techniques and our companions to unravel as shortly as doable.

MH: On the drive to value-based care, Allina Well being has the connection with Aetna and you latterly expanded one with Blue Cross and Blue Defend of Minnesota. Has COVID affected metrics you’ve in place for these?

Wheeler: We’ve had to take a look at a number of the preparations and rejigger them just a little bit based mostly on the pandemic. However the different factor that the pandemic has achieved is it’s proven us the worth of issues that might be perpetuated beneath value-based care.

For instance, we’ve got tele-addiction companies now, and lots of people who find themselves struggling from habit sadly greater than ever earlier than with the isolation of the pandemic are simply loving the companies which are introduced by the entire care group, into their residence. And due to stigma and different causes, they haven’t are available.

A variety of these items that we’re studying will truly be extra invaluable and extra available in a value-based care mannequin. And if something, COVID has truly amplified the explanation for value-based care, to permit for issues like (hospital at residence) and tele-addiction and psychological well being companies.

MH: Tom, have you ever began to rejigger a few of your contracts?

Lindquist: You understand what your present ranges of utilization are. You additionally know what they have been anticipated to be. And in order that’s the place the relationships and partnerships are available. Have an open, sincere dialogue about what’s taking place and the way that impacts the small print of the particular association that you’ve got. The underside line is that value-based care is the longer term.

And albeit, the pandemic has, to Penny’s level, shined a light-weight on a number of the alternatives we’ve got round enhancing outcomes. 

We’ve talked about telemedicine and we talked in regards to the partnerships and we’ve talked about improvements which are coming by as a operate of this pandemic—constructing all of that into enhancing outcomes for people and enhancing well being for populations and reducing prices, I feel everybody wins.

MH: As you look towards 2022 and past, do you must begin with a complete contemporary baseline of metrics due to the pandemic?

Lindquist: You’re not beginning with a contemporary baseline. You’re including some new metrics in—issues just like the telemedicine visits. Check out your utilization and say, “OK, we have been at this degree, now we’re down.” Possibly one of many new metrics is getting (sufferers) again in to see a doctor.