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The #HCBiz Show!


Nov 4, 2021

There’s a lot of unknowns as we head into 2022, but one thing is certain: Health Equity will be a major focus for CMS and CMMI. Gail Zahtz, CEO of PropHealth, tells us that “value-based payment models have failed to deliver on the promise of health equity” and that is a major reason why CMMI paused so many models earlier this year. When the next iteration of value-based payment arrives, you can bet that health equity will be front and center. And for that, we prepare.

“Fee-for-service says you get paid to fix a broken arm. Value-based care says everybody's tripping on the sidewalk and breaking their arm – let’s fix the sidewalk. Health equity says we're going to fix the sidewalk everywhere.” Gail Zahtz, CEO, PropHealth

This is the first episode in a 5-part series: Everything You Need to Know About Value-Based Payment Models to Prepare for 2022 with Gail Zahtz. On this episode, we take a deep dive into everything health equity to lay out what is known, what is unknown, and how you can build flexibility into your business operations and systems to ensure that you are ready for whatever comes next. Key topics include:

  • Why have value-based payment models failed to deliver health equity?
  • What is digital equity and why is it important?
  • Why risk is not the solution on its own especially when you’re only changing the financial model for those you already serve.
  • Risk scoring.
  • Alignment! Alignment! Alignment! That is… patient, provider, and payer alignment.
  • Serving health nomads.
  • The importance (and lack) of race, ethnicity, and gender data.
  • Health equity and value for the Native American community.
  • The value of Federally Qualified Health Centers (FQHC) and how we can use them as a model to design Gail’s “Upside-down ACO”.
  • How to design a community pilot that is effective and sustainable (i.e., good for the patients AND good for the business).
  • How to design your data systems to support health equity initiatives.

Quality measures are next in our 5-part series designed to get you ready for value-based payment in 2022. Subscribe and stay tuned!

For full show notes: https://thehcbiz.com/175-health-equity-is-population-health-vbp-in-2022-gail-zahtz-part-1/