Driving Value Based Care and Learning from Other Industries

Blue Cross and Blue Shield of Minnesota President & CEO on the need to switch to value-based care and the lessons we can learn from other consumer-focused industries.

Key Takeaways: Shifting from fee for service to value-based care is critical in today’s industry. Craig Samitt shares insights about the need to move to value-based care and how the industry can do better in this shift.

By Michaela Katz

Moving from traditional fee for service to value based care promises large opportunities to drive prevention, address broad aspects of health and ultimately transform care.

It seems time that health care companies begin looking at their value beyond that of treatment.

“I think the greatest opportunity is for us to think as wellness companies, social determinant of health companies, protect and prevent companies, not just treatment,” said Craig Samitt, President & CEO of Blue Cross and Blue Shield of Minnesota in an interview at the Health Evolution Summit.

Despite the amazing possibilities that value-based care holds, the health care industry has not fully embraced value-based care as the majority type of provider service.

Progress in committing to value-based care has been slow and obstacles seemingly unmoving.

“I don’t think we’re changing fast enough. The problems that we struggle with or the obstacles to our progress are the same today as they were a year ago, 5 years ago and 10 years ago,” Samitt said. “We’ve been talking about value-based transformation. I actually sense we’re not making progress fast enough in the right direction.”

What are some of the challenges standing in the way of value-based care?

“My sense is that the challenge in the industry is that the profitability of sickness exceeds the profitability of wellness,” said Samitt.

If this is the case, then changes need to be made that financially incentivize wellness.

“We just need to be much more progressive and forceful in driving to value-based payment,” Samitt added.

That’s probably easier said than done but perhaps competition will drive this shift.

“We need to turn the traditional elements of our industry …on its head. I actually value greater competition. I value the vertical integration. I value the innovators and the disruptors,” said Samitt, “The outsiders, so to speak … look at an industry that could improve in service, and access and cost and they have nothing to lose. I would like us, the incumbents, to reinvent health care from the inside out. I think we can do it.”

Watch more episodes of the Health Evolution Interview Series. The next Health Evolution Summit is scheduled for April 1-3, 2020 in Laguna Niguel, California.