LeadingAge New York Adviser Adviser LeadingAge NewYork Spring 2019 final | Page 15

Value-Based Transformation and What
It Means for LTPAC Providers
In a Wednesday morning concurrent session, Brian Ellsworth, vice president of public policy and payment
transformation at Health Dimensions Group, dove into the complicated topic of Value-Based Payment (VBP).
The session, titled Medicare’s Continued Push Towards Value-Based Transformation: What It Means for LTPAC
Providers, moved through key terminology and processes involved in VBP and alternative payment models. The
presentation explained various emerging and expanding models, including Medicare Advantage, Accountable
Care Organizations (ACOs) and bundling.
The session was a crash course in value-based transformation and explained anticipated trends.
“Medicare Advantage is growing,” Brian said, “and is creating a dampening effect on everything else
described.” The bottom line for VBP and alternative payment models is that they will continue
to expand, and Post-Acute Care (PAC) will continue to be under a microscope. Brian
encouraged session attendees to work to understand the operational requirements
of VBP models and innovate wherever possible to best address workforce and
consumer shifts. With VBP, achieving scale is key. With that, Brian also stressed
that partnerships will improve success and that taking on shared risk between
an ACO/bundler and PAC would be a win-win situation: improving quality of care,
reducing administrative costs and safely taking on more downside risk.
The Train Keeps Hurtling Down
the Tracks
A mid-afternoon concurrent session titled The Train Keeps Hurtling Down the Tracks began on Tuesday with a
lighthearted PowerPoint slide to grab the audience’s attention. “The first step is admitting we have a problem,”
said speaker Andy Edeburn, principal at Premier Performance Partners. “The second step is understanding
which problem we’re talking about.” This won a chuckle from the audience as Andy launched into his
90-minute presentation on the trends driving change for aging services leaders.
The session stressed that in order to know where aging services are headed, it is important to take
stock of where we are now. We are right on the cusp of seeing baby boomers entering the
market for long term care, and our current models for payment and health care spending
will not be sustainable with the increase in the aging population. There are also political
realities to consider as there is a continued bipartisan push from fee-for-service to
Value-Based Payment (VBP). Additionally, providers, not payers, are increasingly
accountable for cost and outcomes. Collaboration is on the rise as alignment
continues among physicians and health systems as well as community resources and
non-traditional partners. This foundation of Andy’s presentation made clear that data
insights, analytics, exchange and innovation are key to gaining partners and therefore key to
future success and relevance.
The session offered several takeaways for attendees, including key competencies that will be needed
over the next 15 years. These competencies include an evolving, multidisciplinary workforce; VBP
models; and new care delivery options. Innovative care delivery options will be vital as baby boomers prefer
immediate answers and telehealth innovations. While Andy pointed out that home health is garnering a lot of
investment and attention at the moment, he highlighted care coordination as the real opportunity space for
providers and leaders to begin addressing.
Fundamentally, clinical and operational changes will drive future success. Standardizing care, using evidence-
based clinical pathways to support common patient diagnoses and integrating primary care resources will be
useful strategies in preparing for the next 15 years in long term care.
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