Editor’s note: Shawn Morris retired as CEO on June 30, 2023, but remains on the company’s Board of Directors.
Join us for an insightful, engaging discussion between Shawn Morris, CEO of Privia Health, and Paul Keckley, Managing Editor of The Keckley Report. The conversation covered a wide array of topics: The Biden Administration’s healthcare plan, data bias in social determinants of health, physician alignment strategies for health systems, and much more.
We’re sharing these highlights to give you a “sneak peek” of the 40-minute discussion between healthcare thought leaders. We’ve paired their commentary with relevant industry headlines to help illustrate the throughlines and link their expert commentary to current trends.
Healthcare Transformation vs. the Slow Pace of Politics
The hotly contested, trillion-dollar Build Back Better Act includes several healthcare initiatives: lowering prescription drug prices, continuing Affordable Care Act subsidies, increasing public health infrastructure, and more. After cutting several provisions, such as expanding Medicare to cover vision and dental benefits, the Bill passed the House and currently awaits a Senate vote.
However, that Bill is not the only healthcare legislation underway. Many national healthcare organizations have praised the Value in Healthcare Act of 2021. The bill aims to advance alternative payment arrangements by removing barriers to participation, providing educational and technical support for accountable care organizations, and more. The success of the Medicare Shared Savings Program (MSSP), which saved Medicare $4.1 billion in 2020, may help advance value-based care. The tremendous results showed that, when equipped with the right capabilities, physicians can improve “patient outcomes and lower the cost of care in their communities,” according to Keith Fernandez, MD, Chief Clinical Officer at Privia Health.
Additionally, lawmakers are working to resolve pressing healthcare issues, including:
- Physician shortage.The Resident Physician Shortage Reduction Act of 2021 aims to help offset the growing physician shortage by increasing Medicare funding for medical school. The law would add up to 200 positions annually while requiring the Government Accountability Office (GAO) to “report on strategies to increase the diversity of the health professional workforce, including with respect to representation from rural, low-income, and minority communities.”
- Surprise billing. In 2022, payers and providers must “start complying with the federal ban on surprise billing,” Healthcare Dive reports. The ban, which stems from the No Surprises Act, has received acclaim from consumer groups alongside pushback from providers.
- Telehealth. Stakeholders are encouraging lawmakers to solidify telehealth’s role post-pandemic. Even as utilization tapers off from the pandemic’s record highs, patients are still using the technology far more than pre-pandemic. Simultaneously, experts are encouraging lawmakers to expand broadband access to enable telehealth.
Navigating the Risks and Rewards of Value-Based Care
The Centers for Medicare and Medicaid Services (CMS) has thoroughly outlined and shared an ambitious new direction. The “Innovation Center Strategy Refresh” presents five objectives for the coming years:
- Drive Accountable Care
- Advance Health Equity
- Support Care Innovations
- Improve Access by Addressing Affordability
- Partner to Achieve System Transformation
Two themes that run throughout the agency’s updated vision are enhancing provider education and gradually, responsibly entering risk-based programs. To engage providers, the proposal reviews tools and recommendations to support the transformation as providers assume financial risk, including:
- Making actionable data easily available at the point of care
- Sharing consistent updates to build predictability and inform investments
- Improving data utilization with decision-making support
- Encouraging and supporting “interoperability standards for the exchange of health data”
Responsibly and Effectively Integrating “Big Tech” in Healthcare
Google, Apple, IBM, and other sizable, influential technology companies are making waves in the healthcare space. From cloud computing to artificial intelligence, wearables to chatbots, these companies are seeking new revenue sources by disrupting a traditionally slow-moving industry. Furthermore, new companies are continually entering the healthcare ecosystem. Startups received $6.7 billion in funding in the first quarter of this year alone, Politico reported.
The industry has, in many cases, welcomed innovation. When the Food and Drug Administration (FDA) approved Apple Watches as medical devices, we entered a new era of technology in healthcare. As more and more patients want access to their electronic health records and interoperability gains traction, we’re sure to see an increased presence from Big Tech.
However, we must strive to safeguard the patient-provider relationship from the data-driven impersonality of Big Tech. Paradoxically, these companies are highly consumer-focused and possess great insights into consumer — or patient — behavior. We must carefully integrate the quantitative power of technology with the deeply human elements of medicine: compassion, support, and care. Therefore, it’s critical that we welcome and regulate Big Tech’s role in order to balance patient-provider empathy with technological efficiency.
“Empathy can still happen when providers are seeing, talking with, touching, sensing, listening to their patients, virtually or in person, in a world where decision making actually happens more on the basis of algorithmic outputs,” Nick Cericola, Practice Manager at Advisory Board Research, said in a recent podcast.
Health Systems Partnering for Success
As health systems emerge and rebound from the pandemic, many leaders are searching for innovative partnerships to boost operations. Some health systems are leaning into telehealth while others are partnering with nursing homes. KaufmanHall observed that some forward-looking health systems are partnering with physician organizations that provide “complementary capabilities.”
This approach can combine strategy and scale to enhance existing strengths while improving pain points. “The strength of one partner’s clinical capabilities, for example, may be complemented by the other partner’s health plan capabilities. This can change the dynamic in both partners’ markets,” the report noted. Together, these arrangements can help successfully and rapidly advance value-based care while adapting to fit a health system’s unique regional dynamics.