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Roundtable on New Models of Care Delivery

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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.

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.

Co-Chairs

  • Patrick Conway, MD, CEO of Care Solutions, Optum

  • Mark Ganz, 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

  • Roy Schoenberg, Co-founder, President & CEO, Amwell

  • Mary Tolan, Co-Founder & Managing Partner, Chicago Pacific Founders

Roundtable Partners

Roundtable Fellows

Michael Anderes, Inception Health, Froedtert Health

Tracy Bahl, The Bahl Group

Jonathan Breslau, MD, Sutter Medical Group

Jonathan Broomberg, MD, Vitality Health International

Sunil Budhrani, MD, Innovation Health

Bill Bunker, Navigating Cancer

Norman Chenven, MD, Austin Regional Clinic

Chris Cigarran, Imagine Health

Patrick Conway, MD, Optum

Gaurov Dayal, MD, ChenMed

Natasha Deckmann, MD, AARP Services Inc.

Susan DeVore, Premier Inc.

Michael Dowling, Northwell Health

Esther Dyson, Wellville

Matt Eirich, Humana, Inc.

Joshua Flum, CVS Health

Tad Funahashi, MD, Kaiser Permanente

Mark Ganz, Cambia Health Solutions, Inc

Rebekah Gee, MD, LSU Health - Health Care Services Division (HCSD)

Doug Ghertner, IVX Health

Maryam Gholami, Providence St. Joseph Health

Beth Ginzinger, Blue Cross Blue Shield of Arizona

Robin Glass, Doctor on Demand

Sean Glass, Advantia Health

Joshua Golomb, Hazel Health

Mary Grealy, Healthcare Leadership Council

Michelle Hood, American Hospital Association

Sarah Iselin, formerly of GuideWell

William Johnson, MD, MODA Health

Kim Keck, Blue Cross & Blue Shield of Rhode Island

Dave Kerwar, Mount Sinai Health System

Vinod Khosla, Khosla Ventures

Mark Laret, UCSF Health

Tom X Lee, MD, Galileo

Harlan Levine, City of Hope

Nick Loporcaro, Landmark Health

James Madara, American Medical Association

Thomas Maddox, MD, BJC HealthCare/Washington University School of Medicine

Paul Marchetti, Anthem, Inc

Trevor Martin, Mammoth Biosciences

Mark McClellan, MD, PhD, Duke University

Barbara McNeil, MD, PhD, Harvard Medical School

Rhonda Medows, MD, Ayin Health Solutions

Chris Miller, Paladina Health

Kristen Miranda, CVS Health/Aetna

Mario Molina, MD, Golden Shore Medical Group

Randall Moore, MD, Franciscan Health

Shawn Morris, Privia Health

Farzad Mostashari, MD, Adelade

Mike Mussallem, Edwards Lifesciences LLC

Griffin Myers, Oak Street Health

Colleen Nicewicz, Groups Recover Together

Margaret O'Kane, National Committee for Quality Assurance

Dean Ornish, MD, Preventive Medicine Research Institute

Peter Orszag, Lazard

Misha Palecek, DaVita Inc.

Hal Paz, MD, The Ohio State University

Tim Petrikin, CityLife Health

Brian Pieninck, CareFirst BlueCross BlueShield

Sanjay Pingle, PWNHealth

Deb Rice-Johnson, Highmark Inc.

Matt Rill, MD, Emergency Resources Group and Telescope Health

Chad Robins, Adaptive Biotechnologies

Javier Rodriguez, DaVita Inc.

Iyah Romm, Cityblock

Katherine Ryder, Maven Clinic

Jaewon Ryu, MD, Geisinger Health System

Lee Sacks, MD, Advocate Aurora Health

Roy Schoenberg, Amwell

Lou Shapiro, Hospital for Special Surgery

Sheri Shapiro, Trinity Health

Mark Shaver, Welltower

David Shulkin, MD, Shulkin Solutions

Michael Shumer, Crucial Care

Mona Siddiqui, MD, Humana, Inc.

Lynn Simon, MD, Community Health Systems, Inc.

Kevin Slawin, Trustmark Companies

Scott Smith, Three Rivers Provider Network

Nitin Thakor, GeBBS Healthcare Solutions

Marshall Thomas, MD, Colorado Access

Warner Thomas, Ochsner Health System

Mary Tolan, Chicago Pacific Founders

Kathryn Torres, HCA Healthcare

Susan Turney, Marshfield Clinic Health System

Sara Vaezy, Providence St. Joseph Health

Andrew Watson, MD, University of Pittsburgh Medical Center

Penny Wheeler, MD, Allina Health

Martha Wofford, DaVita 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 Chronic Care Models

Chronic conditions plague many Americans and are a significant driver of high health care costs, and COVID-19 has only exacerbated these conditions as homebound elderly and at-risk patients delay much-needed medical care. This has led to the propagation of new models for managing chronic care that rely on combinations of telemedicine, home visits from PCPs and specialists or advanced practitioners, remote patient monitoring, at-home treatments like IVs and nebulizers, and full-on “hospital in the home” models. Providers and payers need to understand how these models can most efficiently be combined to improve access and quality of care for patients with chronic conditions both during and after COVID-19. The goal of this Work Group is to develop best practices for innovative models of chronic care management that improve patient outcomes and to drive their adoption by payer, provider and life science CEOs.

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