University at Buffalo School of Management

importance of living a healthy lifestyle and hold them accountable for that." Focus on value Many experts advocate for value-based repay- ment models that align providers, payers and other stakeholders around the Triple Aim: a concept by Donald Berwick, MD, former administrator of the Centers for Medicare and Medicaid Services (CMS), that states that health systems should simultaneously improve an individual's care and the health of populations while reducing costs. At Independent Health, a nonprofit health plan with more than 400,000 members in Western New York, this value-based model was the impetus behind its Primary Connection program, developed to sup- port primary care, encourage coordination between specialists and general practitioners in the communi- ty, and improve patient outcomes. "There are many opportunities to provide care by email or phone that are not paid for in a fee-for- service model," says Michael Cropp, MD, EMBA '03, president and CEO of Independent Health. "For participating physician practices, we provide a risk-adjusted prepayment based on the population they serve, and the practice determines how best to use those dollars — some might do more diabetes education, embed behavioral health specialists or em- bed pharmacists. If the practice demonstrates better results, through a combination of quality and effi- ciency, they're able to share in savings to the budget." Cropp says the program has been successful so far on patient satisfaction, controlling costs and im- proving outcomes, including prevention and manag- ing chronic diseases. At Northwell Health, a system with 21 hospi- tals and more than 450 ambulatory and physician practices throughout the metropolitan New York re- gion, Cynthia Khan, BS '95, MBA '97, leads a team to make data-driven, patient-focused decisions for smart growth throughout the system. As vice pres- ident of strategic planning, she works to enhance outpatient services to avoid costly inpatient stays and helped launch CareConnect, the first provider- owned insurance plan in New York State. In addition, Northwell has led the early adoption of bundled payments, a CMS initiative that provides one lump payment for all services provided during a patient's stay and their post-hospital recovery. " There are many opportunities to provide care by email or phone that are not paid for in a fee-for-service model." — Michael Cropp, MD, EMBA '03 President and CEO, Independent Health " [The bundled payment model] helps the patient because it ensures coordinated, best-quality care." — Cynthia Khan, BS '95, MBA '97 Vice President of Strategic Planning Northwell Health 12 Buffalo Business Autumn 2016

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