What a great SHSMD 2019 conference in Nashville! In addition to the fine honor of being asked to present with Rick Shrum, CSO of WakeMed Health and Hospitals on the WakeMed Behavioral Health Network and its accomplishments, we were able to participate in several thought-provoking sessions. Here are the highlights of a couple:
James Sanders, Director of Strategy for University of Utah Health Sciences, presented his research on “Prospective Attribution of Members to Participating ACO.” For many, this may seem like a dry subject, but for those of us negotiating accountable care and shared savings contracts, it is the foundational element to begin negotiations. If we cannot agree on who we are responsible for, we cannot measure our impact. For years, the industry has leaned on a functional compromise from CMS labeled “plurality of care” (whichever provider you have seen the most in the last 12 months is who you are attributed to). This model does not take into consideration patient choice, sentinel health events, and/or specialty health homes (e.g., my trip to the ED last week revealed a heart condition and now my cardiologist provides the bulk of my primary care). James unveiled a conceptual model built on claims data that anticipates the attribution based on patient conditions, history, and plurality of visits. James tested this model against a patient choice database and discovered a more than 80% correlation rate versus a 30% rate using the plurality model. From my point of view, I can envision a future with “Opt-Out” attribution wherein we use smart-matching to assign attribution, notify patient of the prospective match, and ask the patient to notify us if they disagree. This would improve the matching and decrease the administrative burden of getting an affirmed “Opt-In” from 100% of patients.
We also attended a presentation by Christine Varela, Partner with DH, and Amy Blondin, Chief Communications Officer for the Washington State Health Care Authority, wherein they presented https://www.getthefactsrx.com/downloads and their “It starts with ONE" campaign to provide the community, patient, and physician clear, validated facts on Opiate Use Disorder, screening, and methods of treatment. It was heartening to hear hospitals and their marketing/PR departments take a lead role in messaging to their respective communities around OUD. The best gift was at the end when they told us all of the PR Campaign materials were available for dissemination. This is professional quality print, social, and traditional media resources. As Blaze Advisors continues to develop integrated care networks, it becomes more apparent each day the role of coordinated patient, family, and clinician education and messaging to fully engage them in the care team.
Most importantly were the scores of hospital, payer, and policy folks who came to our presentation and cornered us at our booth to talk about the WakeMed Behavioral Health Network. We look forward to following up with you to get the word out. Thanks for your enthusiasm and ideas!