In this latest episode of Claims Denied, Blake sits down with Tim Elliott, CEO of Navvis, for one of the most clear-eyed conversations he’s had on where value-based models are actually headed.
Tim doesn’t deal in buzzwords or wishful thinking. He deals in what’s actually working, what operators are getting wrong, and where the puck is going — whether you’re ready for it or not.
Here were some gems from the discussion which makes the broader convo worth your time:
- Payment innovation will always come out of the government. Tim’s conviction is that DRGs came from CMS, and the next durable models, commercial and governmental alike, will too. Not the private market.
- Tim is a fan of moving more into mandatory risk models. While most operators are bracing against mandatory, Tim thinks the mandatory direction is exactly where we need to go and would tell CMMI to keep pushing.
- LEAD is a no-go right now for most systems. Navvis’ analysis with their partners anticipates very few of them will move to LEAD as it stands today. Benchmarking and settlement math doesn’t pencil yet, so it’s enhanced-track MSSP until they get a few more reps.
- Stop leading with the comp model. Popular belief (that Blake asked Tim about) is that nothing changes in healthcare until physician comp changes. Tim pushed back on this notion hard. At SSM Health, he led with culture first and comp later, and argued you can get pretty darn far before you ever touch the RVU.
- FTEs are becoming FTAs, meaning full-time equivalent agents. His advice was to start drawing your org chart with agents on it. Pretty interesting mental model and paradigm shift.
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Navvis partners with health systems and health plans to deliver real performance improvement across value-based care and fee-for-service models.
https://navvishealthcare.com/vbc
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