Value-Based Healthcare and Payment Models: Including Frontline Strategies for 20 Clinical Subspecialties

Publication
By Julian D. “Bo” Bobbitt, Jr. and Grace E. Terrell, MD, MMM, CPE, FACP, FACPE
Published by American Association for Physician Leadership®

Value-Based Healthcare and Payment Models Including Frontline Strategies for 20 Clinical Subspecialties addresses an issue involving every healthcare organization across the nation – the move from a pay-for-service system to a value-based payment model. An issue that all physician leaders are already quite familiar. The problem is that most healthcare stakeholders lack the expertise to successfully affect the shift from pay-for-service to pay-for-performance models.

To better equip physician leaders, national healthcare pioneers Dr. Grace E. Terrell and Smith Anderson healthcare attorney Julian D. “Bo” Bobbitt, Jr. have culled and vetted key strategies from a large body of sources to create a cohesive, comprehensive 290-page guide for how those in the private and public healthcare sectors can shift from the pay-for-service to a value-based model. Available in print and eBook formats, this book is a no-nonsense deconstruction of the shift to value-based care and the strategies that best serve patient and provider. It serves as a valuable roadmap for physician leaders who are on the frontlines of change and can benefit from clearly defined goals for value-based care that are presented in a positive tone, supported by field-tested examples, and which confer proven reform opportunities. 

Additionally, Dr.Terrell and Bo lay out high-value strategies for twenty subspecialties that addresses the specialty-specific changes in the way medicine is practiced and paid for.

“In the complicated world of payment and delivery system reform,” says Dr. Terrell, “this book deconstructs the most challenging concepts for the novice yet provides sophisticated insights for even the most seasoned executive.”

Bobbitt adds “as value-based care is coming of age, deciding how to start can be an overwhelming task. Risks are high and success with the new models is challenging and time consuming. This book fills an important need by providing concrete and proven strategies to aid in an organization’s successful transformation.”

EARLY PRAISE

“With this manual, leaders of health systems and medical groups can achieve these goals and align their physicians, management, care teams, payers, and patients to deliver exceptional care that will improve quality while lowering costs, resulting in better care, better patient experience, and more affordable health care.” - Jerry Penso, MD, MBA President and Chief Executive Officer, AMGA

“Terrell and Bobbitt provide the steps to provide high quality, affordable care that purchasers and taxpayers expect, and patients deserve.”

“These authors are your transformation coaches, providing starting points for those early in the process, detailed workflow and infrastructure advice for those in the midst of the journey, and sage leadership insights for those who need to motivate and inspire their physician and care teams.”

“Grace and Bo make a complex and ambitious transformation seem achievable.”

“The Value-Based Health Care and Payment Models: Including Frontline Strategies for 20 Subspecialties,” is a gem!”

“Dr. Grace Terrell has been a visionary leader of value-based care for decades … this book should be read by front-line clinicians, physician group and health system leaders, policymakers, payer, and others implementing value-based care models.”

“Useful frameworks for understanding culture change, alignment, clinical redesign, appropriate use of data and technology, and patient engagement.”

“The book describes, in detail, how all providers might participate in the healthcare value chain – including specialists who have struggled to identify their role.”

Table of Contents

Chapter One: Introduction

  • How Did We Get Here?
  • The New Healthcare Is a Team Game
  • The Move to Value Is Not Going Away
  • Change Is Hard

Chapter Two: Elements of Value-Based Healthcare

  • Components of Delivery Systems

Chapter Three: The Thorniest Problems Facing ACOs, and Solutions to These Challenges

  • Challenge 1: Changing the Culture
  • Challenge 2: Obtaining Actionable Data Through Technology
  • Challenge 3: Integrating Care Models and Business Models

Chapter Four: A Deeper Dive into Building Sustainable Value-Based Care

  • Assessing Organizational Readiness
  • Characteristics of a High-Performing Health System
  • Culture and Systems Thinking
  • Leadership
  • Professionalism
  • Strategy
  • Innovation and Design Thinking
  • Change Management
  • Execution
  • Implementing New Models of Care
  • Population Health
  • Clinical Model Design and Management
  • Core Clinical Technology Infrastructure
  • Financial and Network Management
  • Integrated Data and Secure Information Exchange
  • Patient Engagement
  • Population and Clinical Risk Management
  • Components of Patient Care Redesign
  • Development of Care Models
  • Information Integration

Chapter Five: Value-Based Payment Models

  • Categories of Payment Models
  • Payment Model Redesign
  • Design Considerations in Value-based Payment Models

Chapter Six: Optimizing Value

  • Social Determinants of Health
  • Strategic Partnerships
  • Community Ecosystems and Reinvestment

Chapter Seven: Frontline Strategies From Subspecialists

  • Anesthesiologists
  • Cardiologists
  • Child Psychiatrists
  • Dermatologists
  • Emergency Medicine Physicians
  • Gynecologists
  • Hospitalists
  • Nephrologists
  • Neurologists
  • Obstetricians
  • Oncologists
  • Ophthalmologists
  • Orthopedics
  • Pediatricians
  • Primary Care Physicians
  • Psychiatrists
  • Pulmonologists
  • Radiologists
  • Rheumatologists
  • Urologists

Chapter Eight: Conclusion


SOURCE American Association for Physician Leadership®

Order this book online or call 800-562-8088. Bulk order discounts are available in quantities of 100 – 10,000 by calling a Leadership Development Advisor at 800.562.8088. 

The American Association for Physician Leadership® is the only professional organization dedicated to providing education, career support and advocacy to support physician leaders as they create transformative solutions within the rapidly evolving field of healthcare. Learn more at physicianleaders.org.

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