What's Missing in Conversations About Value-Based Care, According to Providence Health Plan CEO

The healthcare industry is slowly moving away from a fee-for-service model and toward a value-based care model. But one thing missing from discussions of value-based care is how it is measured, according to Don Antonucci, president and CEO of Providence Health Plan.

“Some people talk about value-based care and only talk about affordability,” he said in a recent interview at the AHIP 2024 conference held in Las Vegas. “Or they talk a little bit about affordability and quality. But they are sometimes lacking, what does access look like? Is it the right access in addition to affordability and quality? Is there experience for doctors, nurses and providers? …And then how does that translate to the member or patient experience of value-based care? How does value-based care begin to address health equity?

Providence Health Plan, headquartered in Portland, Oregon, has approximately 660,000 members. He has plans for employers, Medicare, individuals and families, and Medicaid. It is part of Providence, a nonprofit health system with 51 hospitals.

Antonucci added that different industries are moving faster than others in the transition to value-based care, like Medicare Advantage. Employer-sponsored plans, however, are moving more slowly. Although Antonucci hopes that will change.

“We need to see – and I think we will – progress on the employer side, because part of what employers are about to experience is a continued double-digit increase in jobs. [the cost of] care, and it’s really not affordable,” he said. “Part of the solution lies in these models. This will control costs, but also improve quality, access and everything else employers are talking about right now.

What gives him a lot of optimism about value-based care is that technology is improving to support the move away from fee-for-service. For example, Providence Health Plan was able to update its claims system and integrate it with its provider partners, helping them share information and provide better patient care.

Providence also has an app that improves care and makes it more efficient, Antonucci added. For example, when he recently went in for his own primary care visit, the doctor was able to have a face-to-face conversation with Antonucci while the information was recorded in the electronic medical record.

“In fact, it gives [the doctor] there’s time and really helps him engage,” Antonucci said. “But what's really cool is that I can click on this app, and the information is now provided to me. And then any follow-up appointments or whatever I have are all created here.

Antonucci added that while “value-based care is not the silver bullet, it is a large part of the direction we need to take to address the challenges we face in health care.”

Photo: atibodyphoto, Getty Images

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