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!
Zahtz has been founding and running mission-driven organizations from the get-go.
Today, Gail Zahtz is the CEO of PropHealth, a value-based administrator that creates and manages healthcare collaboratives to drive clinical and financial success. Their expertise and services focus on contracting, operations and growth for clinically integrated networks, risk bearing entities, and those that fund and deliver healthcare innovation.
Her healthcare career has been guided by these truths: 1) Sustainable change will only happen when every stakeholder gets value, 2) It is good business to “do good” 3) Mission matters, 4) Business can only sustain service with profit (it’s not a necessary evil, it fuels growth), 5) It’s all about experience, 6) The true north is the patient journey – always.
Being mission-driven always has and continues to shape her career. Right out of college, Gail helped to shape health policy in Washington DC. In her first start-up, she addressed work-related health issues for employees through a cause-related marketing agency. Independently she created an award-winning program to reduce the stigma of mental illness by creating a novel public-private partnership.
On many occasions, Gail has spoken to small and large audiences and through social media platforms. She advised the industry on designing for health outcomes and won numerous awards including – Top 100 in Health Info Technology, Top 100 International Influencers in Health Online, Healthcare IT News’ #HIT100, Recipient Walking Gallery of Healthcare, and Top 50 Most Influential Health Leaders. Her public health education campaigns have also been nationally recognized including being awarded the most influential public education campaign by the National Mental Health Association.
As a survivor of late-stage cancer and of domestic violence, she is particularly inspired when sharing her stories of how to survive and thrive despite the most challenging of circumstances to show a way forward to young women everywhere.
To connect with Gail, reach out on Linked In @ https://www.linkedin.com/in/gailzahtz/
PropHealth is a value-based administrator that creates and manages healthcare collaboratives to drive clinical and financial success. Our expertise and services focus on contracting, operations, and growth for clinically integrated networks, risk-bearing entities, and those that fund and deliver healthcare innovation.
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