3 Key Insights from Reuters Total Health 2024
Lucet proudly sponsored Reuters Events – Total Health 2024, which drew providers, payers, pharma and digital health leaders to drive advancements across health care. At the event, Lucet SVP of Provider Success Visar Tasimi spoke on a panel discussing quality metrics for provider networks alongside other industry notables (Nancy Beran of Northwell Health, Tammer Attallah of Intermountain Healthcare, Alexander Ding of Humana, and Edward Mitchell of Advocate Aurora Health). The panelists’ diverse viewpoints sparked discussion about the industry push for standardized quality metrics and strategies for achieving that goal.
Payer-provider alignment is crucial to effective collaboration
Panelists jointly agreed that aligning payer quality metrics with providers is crucial to enabling collaboration and streamlining value-based care. According to Nancy Beran of Northwell Health, “If we aren’t aligned with payers, we can’t implement change down to the practice level. If we want to drive change at a population level, the initiatives and alignment with the payer have to be there.”
When payer objectives are in sync with provider goals, it becomes nearly impossible to drive meaningful transformation. For initiatives to be successful, both payers and providers must work together, ensuring that their efforts are cohesive and mutually supportive.
“The measure set needs to be tech-enabled to be adopted by a wide set of providers,” he said. “That needs to be balanced with policy makers who mandate certain metrics on the front end.”
Visar Tasimi – Senior Vice President, Provider Success
Standardized quality metrics are needed for quality at scale
Standardized quality metrics are essential for creating consistency and accountability in payer-provider partnerships, but varying definitions of these metrics across different payers often cause confusion and complexity. Making sure that these metrics line up will help accelerate positive change in value-based care.
Visar Tasimi noted that technology plays a vital role in integrating payer metrics into provider systems, reducing silos and enhancing care coordination. He emphasized the need for tech-enabled solutions that simplify the adoption of measure sets across a wide range of providers, while balancing the mandates of policymakers.
“The measure set needs to be tech-enabled to be adopted by a wide set of providers,” he said. “That needs to be balanced with policy makers who mandate certain metrics on the front end.”
Another strategy discussed by the panel was utilizing quality bonuses. These bonuses often serve as the gateway into value-based care, but navigating multiple payers can complicate this process. Maintaining clear communication is key to ensuring both payers and providers understand what is required to earn these bonuses.
Tasimi also stressed that health care systems must support providers’ health record management needs at every level—whether they’re using paper-based systems or advanced EHR technology. Technology and data integration can break down the silos so often seen throughout health care. Implementing unified solutions is essential for converting data into actionable insights that enhance patient care.
Simplified processes lead to better patient outcomes
Tammer Attallah of Intermountain Healthcare highlighted that alignment must benefit payers, providers, and most importantly, patients, ensuring that care initiatives focus on helping individuals live their best possible lives.
During the panel, Attallah emphasized that data enablement needs to simplify processes for both providers and patients, with a focus on proactive care, as greater alignment leads to faster progress in achieving value-based care goals. Achieving these goals can help improve long-term patient behavioral health outcomes through coordinated, personalized care.
Lucet is committed to simplifying care delivery through the alignment of payer quality metrics. By fostering strong partnerships and leveraging integrated technology, members can better navigate quality behavioral health care, optimize outcomes and make value-based care more accessible to all.
Rachel Jenkins is a senior marketing specialist at Lucet, The Behavioral Health Optimization Company. Contributions made by Alexa Driscoll, VP of Marketing and Visar Tasimi, SVP of Provider Success.