Most people would agree that there is a lot of uncertainty in the world of population management and accountable care. The transition from volume to value-based reimbursement is challenging and risky. Resources are tight and insurance savings dollars aren’t always forthcoming, but organizations still need to invest in new infrastructure. It can also be difficult to know whether you’re spending resources wisely because some investments won’t pay off for years.
One thing that is clear despite the ambiguity of the current health care environment: you have to engage your clinicians and leaders. An organization cannot simultaneously provide excellent quality of care, reduce costs, and improve the health of the population it serves without care providers and leaders fully appreciating the necessity of pursuing all of these aims.
About five years ago Fairview Physician Associates Network jumped into this new health care world head first with our independent, employed, and academic provider partners. While we still have a long way to go, I can share some of what we have learned over time regarding the keys to stakeholder engagement.
Focus on the Benefits to Patients
Always start by explaining how changes will help patients. I’m an RN with an MBA, and I look at the world from both the clinical and business perspectives. However, if you begin by talking about money — especially with most clinicians — you’ll lose them.
For example, we are working closely with an independent primary care member practice to pilot embedding a behavioral health consultant in their clinic. To help us agree on our clinical and then financial outcomes, we have engaged the providers early in the process. Implementing new delivery models like this requires mutual trust and respect between all parties, and you build trusting partnerships over time, with each encounter.
With clinicians, always lead with the evidence-based rationale — and data they can understand and use — and they’ll be more open to hearing about the business case.
Help People Understand
Take time to educate your stakeholders about accountable care and population management. While everyone has heard these terms, there is still a lot of confusion and misunderstanding. Value-based reimbursement models didn’t exist when most of us went through formal education, so what these changes mean for health care is still unclear to many people.
Build on What You Have
Take a look at your existing governance and infrastructure and use it to strengthen relationships and communication with your stakeholders. Yes, sometimes you need to create new ways of working, but you can also build on what you already have. For example, choose any of your regular meetings or committees and think about how you can weave this work into those discussions. You don’t need to start from ground zero.
This might sound obvious or trite, but you have to make sure the data and the tools you’re offering clinicians are relevant to them and not just used for “shaming and blaming.” Use the data to explain the current status. Work with providers to set goals, determine next steps, and find the resources needed for success. Make it easy for the providers to do the right thing.
At Fairview Physicians Associates Network, we're constantly learning as health care is evolving, but I’m confident that the need to engage clinicians and leaders will not change. They are, however, only one set of stakeholders. We also need to engage our communities and non-traditional partners in the health of our populations. It takes a village!
Barbara Klick, RN, MBA, is Chief Operating Officer at Fairview Physician Associates Network in Minneapolis, Minnesota, and a past participant in IHI’s Population Management Executive Development Program.