This Roundtable supports partnerships between payer, provider and life science companies that accelerate deployment of new care models—including primary care, remote monitoring, expanded telehealth and retail care—that measurably improve patient health outcomes and health equity. This Roundtable will also explore the role of advanced diagnostics in care. Special attention will be given to hospital and primary care resilience during and after COVID and how this reconciles with the drive for efficiency and value over the past two decades. The goal of this Roundtable is to bring to scale models of care that can meet new demand and also advance operation in the new environment of constrained affordability and sustainability.
Each Forum Roundtable strikes a balance between near-term COVID-related challenges and long-term impact on major issues in the post-pandemic world through professional facilitation and deep subject matter expertise. The groups will develop and widely disseminate recommendations that will make an impact on provider, payer and life sciences CEOs, policymakers and thought leaders collaborating for industry-wide change.
Co-Chairs
Patrick Conway, MD, CEO of Care Solutions, Optum
Mark Ganz, former President & CEO, Cambia Health
Mark McClellan, MD, PhD, Director and Robert J. Margolis, MD, Professor, Duke University
Jaewon Ryu, MD, President & CEO, Geisinger
Penny Wheeler, MD, CEO, Allina Health
Industry Advisers
Bill Miller, CEO, WellSky
Roy Schoenberg, Co-founder, President & CEO, Amwell
Mary Tolan, Co-Founder & Managing Partner, Chicago Pacific Founders
Yousuf Zafar, SVP, Medical Informatics, Change Healthcare
Roundtable Partners
Roundtable Fellows
David Anderson, BlueCross BlueShield of Western New York
George Barrett, Formerly of Cardinal Health
Jonathan Bloom, Podimetrics
Bruce Bodaken, Blue Shield of California
Bill Bunker, Navigating Cancer
Wesley Burks, MD, UNC Medical Center
Caroline Carney, MD, Magellan Health
Hernando Celada, ChenMed
Norman Chenven, MD, Austin Regional Clinic
Chris Cigarran, Imagine Health
Mark Clermont, Cecelia Health
Patrick Conway, MD, Optum
Jeffrey Davis, MD, Link Primary Care
Gaurov Dayal, MD, Everside Health
John Deeken, INOVA Health System
Michael Dowling, Northwell Health
Liz Dunne, PeaceHealth
Scott Farr, Pediatric Associates
Tad Funahashi, MD, Kaiser Permanente
Mark Ganz, formerly of Cambia Health Solutions, Inc
Patrick Gilligan, Zaffre Investments
Robin Glass, Included Health
Mary Grealy, Healthcare Leadership Council
Steve Greene, ChenMed
Michelle Hood, American Hospital Association
Sachin Jain, MD, SCAN Health Plan
Larry Jameson, MD, PhD, University of Pennsylvania
Barbara Joers, Gillette Children's Specialty Healthcare
Kris Joshi, Change Healthcare
Vinod Khosla, Khosla Ventures
Paul King, Lucile Packard Childrens Hospital Stanford
Andrew Kobylinski, Primary Diagnostics, Inc.
Mark Laret, UCSF Health
Harlan Levine, City of Hope
Stuart Levine, Chicago Pacific Founders
Paul Marchetti, Anthem, Inc
Steve Martin, Paxton Advisors, LLC
Mark McClellan, MD, PhD, Duke University
Barbara McNeil, MD, PhD, Harvard Medical School
Rhonda Medows, MD, Ayin Health Solutions
Bill Miller, WellSky
Chris Miller, Paladina Health
Kristen Miranda, CVS Health/Aetna
Farzad Mostashari, MD, Adelade
Mike Mussallem, Edwards Lifesciences LLC
Griffin Myers, Oak Street Health
Dean Ornish, MD, Preventive Medicine Research Institute
Misha Palecek, DaVita Inc.
Randy Parker, GeniusRX
Hal Paz, MD, Stony Brook University
Brian Pieninck, CareFirst BlueCross BlueShield
Helena Plater-Zyberk, Supportiv
Mark Prather, MD, DispatchHealth
Tom Priselac, Cedars-Sinai Health System
Matt Rill, MD, Emergency Resources Group and Telescope Health
Deb Rice-Johnson, Highmark Inc.
Javier Rodriguez, DaVita Inc.
Rachel Roiland, PhD, Duke-Margolis Center For Health Policy
Jaewon Ryu, MD, Geisinger Health System
Lee Sacks, MD, Advocate Aurora Health
Dean Sawyer, Freespira
Paul Scheel, Washington University School of Medicine
Tom Schenk, MD, HealthNow New York, BlueCross BlueShield of Western New York
Roy Schoenberg, Amwell
Michael Shumer, Crucial Care
Mona Siddiqui, MD, Humana, Inc.
Lynn Simon, MD, Community Health Systems, Inc.
Mary Tolan, Chicago Pacific Founders
Kathryn Torres, HCA Healthcare
Susan Turney, Marshfield Clinic Health System
Michael Uchrin, Monogram Health
Sara Vaezy, Providence St. Joseph Health
Andrew Watson, MD, University of Pittsburgh Medical Center
Penny Wheeler, MD, Allina Health
Ron Williams, RW2 Enterprises
Bryony Winn, Anthem, Inc.
John Woolley, Hatfield Medical Group
Felicity Yost, Tia Inc
Work Groups
Work Groups are chartered by Roundtables to go deep on a key issue over a three-year period, and to make recommendations to Roundtable Fellows for pronouncements or actions that should be taken by the Roundtable, the Forum or by all CEOs. Work Groups are focused on:
- Developing specific mechanisms that advance access to high-quality, affordable health care for all people
- Identifying best practices and developing strategies for wide dissemination so observable results can be realized within 3 years
- Addressing issues that CEOs and boards of payer, provider and life science companies would consider top priorities
- Driving changes where the voice of payer, provider and life science CEOs and their actions matter, where private sector leaders can make progress without regulatory change and which do not require endorsement of specific products or solutions
Chartered Work Groups
Leveraging VBP to Increase Health Care Value & Resilience
Health care systems implementing value-based payment (VBP) care models have demonstrated their potential for improving efficiency and patient outcomes by reducing hospitalizations, specialty care and emergency room visits. However, despite years of public policy and private market efforts, VBP arrangements represent the minority of reimbursement to the industry, and most health care systems have numerous specific, often conflicting, VBP arrangements from health plans, Medicare and other contractors. Beyond this, only a small share of VBP arrangements are two-sided, containing both incentives for better performance and downsides for worse performance. Although the steady revenue stream from VBP arrangements has given some relief to at-risk providers during the COVID-19 pandemic, the future of VBP arrangements in a future of austerity and profound access-to-care issues is uncertain. The overarching goal of this Work Group is to increase the prevalence of VBP arrangements among providers and payers by identifying and reducing barriers to adoption in order to improve efficiency and patient outcomes.
Reinventing Primary Care and Preventative Care Models
Primary care has moved over time from solo practices and small groups to being vertically integrated into hospital systems or horizontally integrated into corporate groups, a trend that is being accelerated by the financial pressure from the impact of COVID-19 on primary care practices. At the same time, new primary care models are emerging such as at-risk primary care groups, concierge services, telemedicine and retail-based models. More will be demanded from primary care practices as the country emerges from the pandemic and as its citizens continue to age to provide better preventative care for patients. More than ever, payer, provider and life science organizations have the opportunity to provide more continuous health care through multi-channel platforms in order to optimally meet the needs of those they serve. The goal of this Work Group is to develop templates for operating primary care practices across sites based on the type of provider and patient population that optimizes use of new technologies and leverages the skills of the entire health care workforce.
Advancing Innovative Home-Based Care Models
Home-based care can reduce health care costs and provide more patient-centered care. Covid-19 created a new urgency to deliver care in the home, and combined with temporary changes in reimbursement from some payers, led many to implement innovative home-based models. However, conflicting stakeholder views of home-based care, such as a lack of consensus on evaluating quality and outcomes or measuring value, continue to be a barrier to adoption. The goal is to enable the adoption of innovative home-based care models, identifying best practices for the systematic implementation, evaluation, and payment of high-value home-based care.
