Key Lessons on Value-Based Care Collaboration in Advanced Primary Care Efforts
Pushing past competitive impulses to pursue value-based care collaboration is difficult to achieve among healthcare stakeholders, but a worthwhile endeavor.
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- In 2019, a group of payers, providers, and other healthcare stakeholders converged to reimagine advanced primary care in the state of California through value-based care collaboration.
The California Quality Collaborative (CQC) is a Purchasers Business Group on Health (PBGH) program that started in 2004 under a different name. The group’s goal was to improve quality of care in a collaborative way, according to Crystal Eubanks, senior director of care redesign at the PBGH.
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“Many of these providers and practices are contracted with multiple health plans, multiple intermediary provider organizations like independent physician associations or medical groups. We share this delivery system. We can't solve this alone. So how do we come together and prioritize the support that they need?” Eubanks explained on Healthcare Strategies.
PBGH has worked extensively with providers, offering technical assistance for the transition to value-based care. With federal funding and a few years of work, the organization saw positive results from its technical assistance program. After about four years, Eubanks and her team achieved cost savings of $180 million across 4,500 providers who served around 3 million Californians.
But over time it became clear that the program needed to broaden its vision.
“You can do a lot of technical assistance, but until you remove some of the upstream barriers, the system barriers, it's hard to make that even more effective and really deliver on the hopes and potential for the practices,” Eubanks said. “We can only do so much technical assistance for so long. It's not going to get us there. We actually need to change the business incentives.”
Eubanks and her team at PBGH and CQC wanted to increase the number of high-performing healthcare practices delivering advanced primary care.
That is what drove a collection of healthcare stakeholders to gather in Oakland, California in 2019. The group started by establishing a statewide standard for rewarding high performance in advance primary care and determining what quality measures would best support these goals. But the conversation hit a roadblock when it came to payment structure.
The process of working through the differences, setting aside—at least in part—competitive ambitions, and pushing for results highlighted the challenges and benefits of value-based care collaboration between stakeholders, as Eubanks expounded on Healthcare Strategies.
