When Pat Blake, President of McKesson Technology Solutions, introduced a panel discussion his company sponsored on Tuesday at HIMSS, he succinctly stated the challenge facing physicians, payors and the industry that supports them:

“Providers and payors are focused on cost, quality and outcomes,” said Blake. “But it is incredibly complex and challenging to materially move the needle related to performance.”

The panel, which consisted of five experts with different backgrounds, shared their insight on everything from their support for value-based payments to a longing to return joy to the practice of medicine.

Moderator Mary Grealy, president, Health Leadership Council (HLC), a coalition composed of chief executive officers within all disciplines of the American health care system, led the discussion, entitled “Establishing Stability in a Climate of Uncertainty.”

The panel consisted of:

Dr. James Barr, a family medicine specialist and vice president of Clinical Intelligence, Atlantic Health System
Lili Brillstein, MPH, director Marketplace Innovations, Horizon Blue Cross Blue Shields, New Jersey
Mark McAdoo, vice president, McKesson Health Solutions, and former CEO of HealthQX
Dr. Zak Ramadan-Jradi, MBA, executive director and vice president of Accountable Care, MultiCare Connected Care

Grealy asked the panel several questions and responses are paraphrased below.

“What is the single biggest barrier to moving the current system and where we should be going?”

Ramadan-Jradi – We need to understand and agree on why we’re moving to a value-based model first, and not so much how. We need to take the message to the employers because they’re not sure what it means in regard to delivering quality and outcomes. How do you get the employer to move from a PPO model to an ACO model? I’m seeing us trying to move, but we’re still running a traditional system. This is quite expensive. How long until we make the leap of faith to move to a value-based system?

Barr – We need to move from the bottom up. Interoperability is a problem. We have 93 EMRS, trying to aggregate data and extract information is not easy. Return on investment is very challenging, we need to make models impact 20 percent of revenue to make a business case – five or 10 percent (at risk) is not enough.

Brillstein – I see it around the country, we’re making the transition too fast, no one knows what to do yet (with at-risk models). I like a no-risk model because it is more collaborative.

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