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Roundtable on New Models of Care Delivery

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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

  • Kris Joshi, EVP & President, Network Solutions, Change Healthcare

  • Bill Miller, CEO, WellSky

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

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

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

Hernando Celada, ChenMed

Norman Chenven, MD, Austin Regional Clinic

Patrick Conway, MD, Optum

Jeffrey Davis, MD, Link Primary Care

Gaurov Dayal, MD, Everside Health

John Deeken, INOVA Health System

Liz Dunne, PeaceHealth

Scott Farr, Pediatric Associates

Tad Funahashi, MD, Kaiser Permanente

Mark Ganz, formerly of Cambia Health Solutions, Inc

Patrick Gilligan, Zaffre Investments

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

Kris Joshi, Change Healthcare

Vinod Khosla, Khosla Ventures

Andrew Kobylinski, Primary Diagnostics, Inc.

Harlan Levine, City of Hope

Steve Martin, Paxton Advisors, LLC

Mark McClellan, MD, PhD, Duke University

Rhonda Medows, MD, Ayin Health Solutions

Bill Miller, WellSky

Chris Miller, Paladina Health

Kristen Miranda, CVS Health/Aetna

Farzad Mostashari, MD, Adelade

Griffin Myers, Oak Street Health

John Olympitis, Welltower

Dean Ornish, MD, Preventive Medicine Research Institute

Misha Palecek, DaVita Inc.

Randy Parker, GeniusRX

Brian Pieninck, CareFirst BlueCross BlueShield

Mark Prather, MD, DispatchHealth

Tom Priselac, Cedars-Sinai Health System

Matt Rill, MD, Emergency Resources Group and Telescope Health

Javier Rodriguez, DaVita Inc.

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

Susan Turney, Marshfield Clinic Health System

Michael Uchrin, Monogram Health

Sara Vaezy, Providence St. Joseph Health

Andrew Watson, MD, University of Pittsburgh Medical Center

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.

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