Chip Howard is Senior Vice President of Partner Services at Remedy Partners, the nation’s leading bundled payment company. He is responsible for leading Remedy’s field teams that work hand-in-hand with provider partners to ensure success under bundled payment arrangements. With Mr. Howard’s leadership, Remedy’s Partner Services teams enable provider partners to use its vast suite of tools, resources, and capabilities to improve outcomes and quality as well as promote cost effectiveness.At Convergence, Mr. Howard will speak about Remedy Partner’s experience with episodic payments and some of the critical issues to consider for commercial bundles between providers and payers.
This is the latest in a series of interviews that Chilmark Research is conducting with Convergence speakers prior to the event. The interview has been lightly edited for grammar and clarity.
Why is it important for the healthcare industry to take the emergence of payer-provider convergence seriously? What do you see in your work that makes this particular topic important to you?
Payer-provider convergence is essential to the success of value based models. Each sector brings vital people, tools, and capabilities to the table, and only by blending those together can better outcomes, better quality, and cost efficiencies be achieved. In my work as SVP, Partner Services at Remedy Partners, my team and I work every day in the field directly with our provider partners in the Bundled Payment for Care Improvement (BPCI) initiative to drive better results for our patients and our respective organizations. I see that when goals are aligned and there is collaboration across the care continuum, care and cost outcomes are dramatically improved. The same should be expected when payers and providers align against the same objectives.
Post-acute strategies are essential to success under bundled payment programs…Selecting the proper post-acute setting, ensuring the appropriate use of care in this setting, and preventing hospital readmissions from post-acute are all key focus areas to ensure the best outcomes while also managing health care resources efficiently
Convergence and value-based care are closely linked. What do you think it will take for the industry to accelerate the shift towards value-based care?
We have already seen a significant shift towards value-based care in the adoption of primary care, ACO, and bundled payment models as evidenced by an estimated 25% of healthcare dollars flowing through alternative payment models in 2016 (HCPLAN Measuring Progress: Adoption of APMs in Commercial, Medicare Advantage, and State Medicaid Programs). Continued acceleration will be driven by both payer and provider organizations and, of course, by success in these models.
Do you see more of a public or private payer emphasis? How much interest do you see in this as a mandatory vs. voluntary process, especially in the area of bundled or episodic payments?
My view is there will be an emphasis by both public and private payers going forward as these models continue to show results for both sectors. My personal perspective on voluntary vs. mandatory is that voluntary models offer a better chance for success as convergence should be driven by true trust and a partnership approach where all parties are invested in the success of each other.
Do you think that the CMS announcement (PDF) scaling back bundled payment programs will have a dramatic impact on this market, or do you think that will be a minor issue and a temporary pause?
I believe that the recent announcement will be a minor issue/temporary pause. I think it is a very minor issue as it focused on scaling back mandatory bundles in just two areas. The reality is that the success of voluntary bundles speaks for itself. We are focused on creating long-term and systemic change, and the best way to do that is having all parties fully invested in and dedicated to the success of the program.
While everyone is still awaiting the CMS rule on the next iteration of BPCI, Remedy Partners sees strong interest with existing participants as well as potential new entrants to the program.
Do you think hospitals will continue to move forward with their post-acute strategies and optimization of post-acute networks or, or opt wait and see, in terms of other procedures or surgical areas?
Post-acute strategies are essential to success under bundled payment programs, especially BPCI and CJR, so I see that continuing. Selecting the proper post-acute setting, ensuring the appropriate use of care in this setting, and preventing hospital readmissions from post-acute are all key focus areas to ensure the best outcomes while also managing health care resources efficiently. Remedy Partners has collaborated with our provider partners to build a strong network of post-acute providers and we will continue that work going forward.
Do you think that the roadblocks to broader acceptance of convergence are more strategic, tactical, operational, or cultural in nature? Or are any of those particular factors more pressing than others?
While all the above factors can be roadblocks to progress, tactical and operational issues can usually be resolved by diligently working together. Strategic and cultural issues can prove to be more difficult to navigate and also set the tone (for better or worse) in a value-based partnership, so those two are more pressing from my perspective.
What organizations other than your own do you consider to be leaders in convergence especially in regards to bundled payments?
There are several organizations that I consider to be leaders in the bundled payment space. Aside from the obvious choice of CMS for traditional Medicare, there are multiple states that have built significant bundled payment programs to support Medicaid patients (Arkansas, Tennessee, and Ohio to name a few). On the commercial side, regional payers such as Blue Cross Blue Shield of Arkansas and Horizon Blue Cross Blue Shield of New Jersey have built successful programs.
Do you think that episodic payments will drive increased coordination of care, or do you think other market drivers will accelerate the need for coordinated care?
Episodic payments will continue to drive increased coordination of care as hospitals, physicians, and post-acute providers work and communicate better in order to achieve outcome, quality, and resource efficiency goals. But other forms of value-based models will also serve to accomplish the same, but in different ways or perhaps not always as effectively because episodes of care are so targeted.