What’s the difference between value-based care and value-based payment? How can we attribute outcomes and cost savings to specific innovations in care delivery? Does anyone really know what they’re doing? What do the patients think? Who needs to be at the table to figure this all out?

On this episode, guest-host Janae Sharp asks Don Lee and Shahid Shah about the VBP Forward Conference happening in Buffalo on February 20th and 21st. And we try to break down what’s really happening in the move from Fee For Service to Value-based healthcare.



This episode is sponsored by VBP Forward:

VBP Forward will host its inaugural conference February 20-21, 2019 in Buffalo, NY at the Hyatt Regency Buffalo. The conference will bring together over 200 professionals who serve Medicaid and Medicare special needs or complex populations or have an interest in that value chain. Participants will gain insight into the next generation of value-based payment and will be provided with a roadmap for their path towards effective value payment for special needs populations. In addition to clinical providers, VBP Forward will have a track and focus on guiding community-based organizations down the right path for the collection of social determinants of health and how they can become not only an integral part of care delivery but also the revenue cycle associated with that delivery.

Show Notes and Timestamps

0:50 – Why Buffalo? And why the focus on Medicaid and Medicare special needs and complex populations?

3:35 – What is the difference between Value-based care and Value-based payment?

The 3 building blocks necessary for Value-Based Payments.

“Value-Based Payments are a mechanism by which we are trying to figure out what are the things in Value-Based Care that I’m willing to pay for and how will I pay for them? Will I do it at a population level? Will I do it for a specific outcome?“

10:14 – How do you attribute outcomes and cost savings? The roadmap of VBP Design:

”Listen to the roadmaps. If we’re having the same conversation, if we know where the state and health plans are trying to drive things, if [providers] know where your service fits in, now we can talk about how do you structure your service in a way where you can provide a credible value proposition back to them… [and] articulate that in a way that matches their business models.”

14:29 Are we basing outcome goals on evidence or just assuming certain outcomes are possible? How sophisticated plans and health systems could be designing computer simulations to learn what’s possible.

22:00 Who needs to be at the table for these conversations?

  • New York State and CMS
  • Health Systems
  • Managed Care Organizations
  • Community-Based Organizations
  • Health Foundations

26:04 Call BS where you see it. What have you seen in the evidence and at scale vs. what is the experiment? If I’m the experiment, TELL ME!

29:33 Getting nonprofits from grant-funded model to a VBP model.

31:53 Shahid’s QE3 framework (Quantitative Expectations, Evaluations, and Evidence) for integrating the patient into VBP design.

36:44 How are we going to measure if patients are improving their relationship with our health care system and the social care system?

37:55 Move beyond the wish stage and bring it to reality. The VBP Forward conference is not about lectures. We’re bringing people together for a conversation. We want you closer to taking action rather than just being more educated about topics.

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About Janae Sharp

Janae Sharp is a physician suicide loss survivor and the Founder and CEO of Mdsuicide.com and the Sharp Index, a nonprofit dedicated to better physician mental health. She loves to match-make to solve problems. Her main work involves healthcare data and analytics marketing to improve healthcare outcomes for the under-served. Janae has learned to code in python, and enjoys making communication easier in tech production, but her true passion is in matchmaking companies to create elegant health IT systems and improve health. She has worked with interoperability and social determinants of health and is an expert on patient and physician engagement. Janae has three children, enjoys learning new things, hiking, triathlon, and quilting.

Find her on Twitter at @CoherenceMed or on LinkedIn.

You can also find some of her great writing here.


About Shahid Shah

Shahid N. Shah is an internationally recognized and influential healthcare IT thought leader who is known as “The Healthcare IT Guy” across the Internet. He is a technology strategy consultant to many federal agencies and winner of Federal Computer Week’s coveted “Fed 100″ award given to IT experts that have made a big impact in the government. Shahid has architected and built multiple clinical solutions over his almost 24 year career. He helped design and deploy the American Red Cross’s electronic health record solution across thousands of sites; he’s built several web-based EMRs now in use by hundreds of physicians; he’s designed large groupware and collaboration sites in use by thousands; and, as an ex-CTO for a billion dollar division of CardinalHealth he helped design advanced clinical interfaces for medical devices and hospitals. Shahid also serves as a senior technology strategy advisor to NIH’s and TATRC’s SBIR/STTR program helping small businesses commercialize their healthcare applications.

Shahid runs three successful blogs. At http://shahid.shah.org he writes about architecture issues, at http://www.healthcareguy.com he provides valuable insights on how to apply technology in health care, at http://www.federalarchitect.com he advises senior federal technologists, and at http://www.hitsphere.com he gives a glimpse of the health-care IT blogosphere as an aggregator.


About Don Lee

Don is an accomplished Health IT expert with a 20-year track record of driving value with technology.

Don began his career as a custom software developer and eventually built and lead a team of more than 30 engineers.  Later, he was the subject matter expert, product manager and head of sales and marketing for a digital health startup that launched a SaaS-platform focused on administrative simplification in healthcare.

Today, Don is President of Glide Health IT, LLC, a consulting firm that helps forward-looking organizations align their Health IT and business strategies. The firm specializes in business and product development with a focus on data aggregation, interop, analytics, and quality measurement.

Don is also the founder, co-host and Executive Producer of The #HCBiz Show!, a podcast dedicated to unraveling the Business of Healthcare.

LinkedIn: https://www.linkedin.com/in/donleehit


Related and/or Mentioned on the Show

Center for Elder Law and Justice

Health Foundation for Western and Central New York


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