Section I: New Urgency in the Transition to Value-Based Care
The U.S. health care system is quickly moving toward a care delivery model that encompasses entire populations, not just the patients who present themselves for care. This is because many at-risk individuals in the community seldom, if ever, seek treatment or health screenings—and they have a disproportionate impact on total health care spending.
The purpose of population health management is to reach all community members “upstream” before they experience late-stage, preventable illnesses. To accomplish this goal, hospital and health plan boards must reshape governance structures, acquire new competencies and forge new alliances outside the hospital walls. Improving population health requires much more than a vague mission statement.
The task demands dynamic, informed board leadership. In the past, hospital boards have typically drawn on the talents of current/former physicians and local business and faith leaders. As value-based care becomes the prevailing model in U.S. health care, board composition needs to widen to include trustees with a deep understanding of risk management, data analytics and care management. Boards can also benefit from fresh perspectives from members with experience in public health, wellness and organizations that successfully engage people in healthy behaviors, such as Weight Watchers, the YMCA and other local fitness centers.
In any industry, it’s seldom the leaders who embrace disruptive innovation. For example, when Tower Records faced a new competitor in music distribution, Apple’s iTunes, it was reluctant to move to a new business model before it was too late. Likewise, many successful health care organizations are finding it difficult to detach from the fee-forservice model. But now is the time for action, not delay. The shift to value-based care is sometimes characterized as a deep dive, but it’s actually a transition that can be managed in a thoughtful, step-by-step manner.