New C-Suite role seeks to grow value-based care payments

Organizations are increasingly choosing C-suite executives to lead value-based initiatives, as evidenced by Nemours Children’s Health System’s recent chief value officer hire.

Handling alternative payment models is typically the responsibility of a director or a vice president, but designation of a “chief value officer” brings the duty up to a new level of emphasis and authority.

“What it signals to folks is that focusing on value-based care requires a high level of executive presence,” said Rick Kes, healthcare partner at RSM. “To negotiate a contract with the payer, to embrace value-based care, and then to execute it.”

Several major health systems and facilities have appointed chief value officers in recent years to work on value-based care growth and managing risk-based contracts, including Novant Health, UNC Physicians Network, Mayo Clinic and NYC Health + Hospitals.

Nemours Children’s Health announced this week that Karen Wilding will serve as chief value officer and oversee teams working on population health and care management, electronic health record system data analytics and investment in value-based payment models, the pediatric health system announced on Monday.

As chief value officer, Wilding said she will focus on facilitating strategic partnerships with payers, community members and industry leaders around value-based care payment and care model design.

“We’re moving away from just providing greater volume, and really focusing on health outcomes, quality of care, accessibility and quality of life,” said Kara Walker, chief population health officer at Nemours Children’s Health.

Some see chief health and value officers as strategic ways to make community connections, gain patient trust and address housing and environmental issues that are exacerbating underlying health conditions, said Tom Cassels, president of Rock Health Advisory.

In the next couple years, Kes said more health systems will likely roll out a chief value officer position as they begin to focus on value-based care as the next step for the industry; similar to how facilities have invented chief strategy officer and chief patient experience officer roles.

“It’s critical to put somebody in charge of this whole mentality of changing health systems to be value based,” he said. “It’s a lot of work, change, management, and a lot of education of physicians, nurses and everyone in [the] system.”

COVID-19 likely pushed more systems to see alternative payment models as a more sustainable option because the health systems that had the most success during the pandemic were those that had a more predictable cash flow, Kes said.

Regardless of whether organizations create this value-based care role, Kes said more are starting to look for expertise and skill sets in population health and value-based care when hiring new talent and even CEOs or chief financial officers.

This change is reflective of change happening at the executive level, with legacy CEOs being replaced by younger people and recognizing that the healthcare environment is changing and the status quo isn’t good enough anymore, said Michael Abrams, co-founder and managing partner of Numerof & Associates.

Executive teams are likely hedging their bets and trying to save the healthcare industry from crashing and burning due to unstoppable rising costs, Abrams said. They are identifying what needs to be done to adapt and transform, and tasking people at the highest management positions to ensure This fundamental transformation happens.

Still, for some, the appointment of chief value officer could just be virtue signaling and the real impact will depend on the implementation, the budget and authority these executives are given, he said.

“If the addition of a chief value officer is a change in title only, that would be a disappointment,” said Melinda Abrams, executive vice president for programs at the Commonwealth Fund. “However, if it provides executive leadership on how to think comprehensively about delivering value to patients by improving quality, lowering costs and advancing equity, that would send a substantial signal to all the providers in that system.”

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