Summary
In this episode of the Value-Based Care Corner, John P. Carter sits down with Dan Roberts of Value Services Management (VSM) Group to discuss how value-based care is expanding beyond traditional primary care models and creating new opportunities to engage specialists, post-acute providers, and other care partners.
Dan explains how VSM supports ACOs by building strategies around the needs of individual providers and patient populations rather than applying a standardized operating model. The discussion explores the unique challenges of managing institutionalized patient populations, including the need to optimize provider time, strengthen clinical support, and reduce unnecessary emergency department utilization.
John and Dan also discuss the growing role of specialists and post-acute providers as CMS and CMMI continue refining value-based payment models. As organizations prepare for greater downside risk, they explore how stronger collaboration, more efficient workflows, and the appropriate use of AI can help organizations manage rising-risk populations while making better use of limited healthcare resources.
Key Takeaways
- Value-based care is expanding beyond primary care as specialists, technology companies, and other stakeholders become more involved.
- Successful ACO strategies should account for the unique workflows, needs, and operating environments of participating providers.
- Institutionalized patient populations require a different approach to care coordination than traditional outpatient populations.
- Post-acute providers can play a larger role as care partners rather than simply serving as discharge destinations.
- Increasing downside risk is creating greater pressure for organizations to improve efficiency and prepare operationally.
- AI can support rising-risk populations and workforce efficiency when implemented around effective people and processes.
What You’ll Learn
00:57 – Why value-based care is expanding beyond primary care to include specialists and other stakeholders
03:47 – How to build ACO strategies around provider needs and operating environments
05:33 – Why institutionalized patient populations require a different value-based care approach
06:32 – How collaboration with post-acute providers can strengthen continuity of care
08:22 – How increasing downside risk is driving the need for greater operational efficiency
08:40 – How AI can support rising-risk populations and help healthcare organizations better allocate workforce resources
