Chief Healthcare Executive Roundtable: The promise and problems with value-based care

For years, healthcare leaders have discussed the need to shift away from the fee-for-service model of healthcare and move towards value-based care.

During the Chief Healthcare Executive Roundtable, our panel of leaders said there is genuine potential with moving to a system that focuses on keeping people healthier.

But they also said reimbursement models make it difficult.

These top healthcare leaders participated in our roundtable.

• Robert Garrett, CEO, Hackensack Meridian Health
• Benjamin P. Levy, MD, clinical director of medical oncology, Johns Hopkins Sidney Kimmel Cancer Center
• Kevin Beiner, chief operating officer, Northwell Health
• Deepak L. Bhatt, MD, M.P.H., M.B.A, director, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine
• Stephanie Wierwille, moderator; EVP, strategy and innovation, BPD

Check out the video for the discussion on value-based care. Here are some highlights.

‘A challenge in the U.S.’

Bhatt recalls the conversations around value-based care taking place years ago.

“Value-based care seems like it's coming any year now, and it has for the past several years,” Bhatt says.

Bhatt said he’s someone that believes in value-based care. But he says that the model hasn’t really been adopted on a large scale.

“I think it's a really good paradigm, especially to promote prevention, not just cardiovascular prevention but cancer prevention and overall health and wellness,” he says. “But it's a challenge in the U.S., if I'm being candid, to transition from what is still largely a fee-based system, one that largely rewards procedural care, to one that is value-based.”

Garrett says there are many headwinds involved with value-based care.

“If you look at the total stream of revenue, most of it is still traditional fee-for-service,” Garrett says. “So it has to be a factor as we come to the table and talk about affordability. The problem is that the incentives have not been aligned between provider and insurer, especially on the downside risk side. We've seen some good outcomes on upside-only, but when you get to the downside, that's where the rubber hits the road, and there has to be a true balance in risk-sharing between provider and insurer.”

Levy says he sees the merits of value-based care, but also points to the hurdles that impede the transition.

“It's so hard to define value, and standardizing metrics to measure value and patient experience, not only within one discipline but across all specialties, is not an easy task,” Levy says. “There's a lot of work cut out for this endeavor. It's not something we can't overcome, but we certainly need to reevaluate how we're going to define value.”

Northwell has taken some incremental steps, but the system is treading lightly, Beiner says.

“As the affordability discussion advances one way or another, providing value-based care is doing more with less, or doing high quality with less,” Beiner says.

See all the videos

You can see all of the videos from our series on the Roundtable page. We divided the roundtable discussion into a series of smaller videos designed to fit into the busy schedules of healthcare leaders. The panel tackles AI, business trends, the well-being of employees, and other big topics. And we have a couple of more videos still to come.

The videos are free to watch, but you will be asked to fill out some information to access them. Check out the conversation.