Partnering for Progress: Providers and Payers Need Support to Fully Align on Value-Based OB Care, According to Dr. Brian Klepper

Dr. Brian Klepper is a health care analyst, commentator and entrepreneur. He is CEO/Principal of Worksite Health Advisors, a benefits consultancy focused on linking high performance/high impact health care organizations with purchasers. He recently spoke with Wildflower about the importance of finding the right partners to move the needle on value-based care in the maternity setting.

It can be tough to align healthcare stakeholders, even when everyone agrees on a desired outcome. With value-based care, do you think payers and providers need additional help to broker more effective partnerships?

There’s a lot at stake here, and it’s really hard to find alignment and one version of the truth. I think it’s necessary to have a third party engaged to broker this discussion and to ensure all stakeholders’ interests are being met. Our system is broken at its core. That’s why I feel that the real pressure to fix it will come from the outside, i.e. purchasers and patients, and that the best innovations will come from third-parties who have designed better mousetraps for solving specific problems.

How do payers and providers find the right partners to support the move toward value-based care?

When you’re evaluating vendor partners, there is a common sociology that you should be considering. Solution providers should have a clear and strong mission, be driven by data and evidence, possess specific subject matter expertise in a niche area and have a truly different and unique solution for an existing problem. They need to have a track record of success and be confident enough in their solution to put fees at risk based on performance.

I believe organizations should look for partners who are best-in-class and best-of-breed. That is a more effective way to partner to push priorities forward, versus generalists who don’t have a specific set of expertise or settling for the best solution you can find in your local market. For specific challenges you have, you need to find a high-performance vendor who can address them.

Are there specific questions you consistently use for vetting potential partners?

Few organizations put in the effort required to thoroughly evaluate partners.  Those who are committed to the exercise should ask the following key questions of any potential partner:

• Do you have longitudinal data that demonstrates you can consistently deliver better outcomes and lower costs?
• Can you provide client testimonials and contact information for organizations you have helped achieve these outcomes?
• How does your product or service scale effectively? Can you produce results across different population types?
• Is your solution sticky? Can you sustain engagement over time?
• Does your offering integrate into the rest of the healthcare ecosystem? Is it seamless for the patient, the provider, the payer and the purchaser?
• Are you confident enough to put fees at risk against your performance?

Specifically focusing on value-based care in the maternity setting, you believe it’s important to base decisions on value, not cost. Can you elaborate?

Not all solutions in this space will be inherently cheaper. In some cases, you might not be saving money immediately, but if you’re doing the right thing for the health of a mom and baby, I don’t think saving money should be a gating event. You have to focus on the outcome first and then lower costs will follow. You can’t compromise the outcome because you’re too focused on ROI. That doesn’t make a lot of sense and won’t work out in the long run. It doesn’t matter what you’re paying, if your efforts return appropriate value. Part of that value can be monetary, but some of it should be the quality it created. Put simply, don’t buy on price, buy on value.

Technology obviously plays a role in advancing the transition to value-based care, and in improving maternal health outcomes. But is there really an app for that? Or will it require more?

In general, we haven’t performed well as an industry when it comes to women’s health. An app alone is not going to fix it. Investors have poured $50 billion investing in digital health solutions, and we haven’t seen nearly enough high-impact disruption from the space. We have an alignment issue in healthcare, and we have too many companies who are bringing superficial solutions to the marketplace that don’t have the efficacy or the evidence to drive change.

Being able to leverage an integrated platform in maternity care to facilitate better preterm and postpartum support would be powerful. Properly equipping patients and providers will lead to more effective identification of high-risk patients, reductions in emergency room visits and a boost in the percentage of babies who thrive.

For more expert insights and discussions around value-based care in the maternity setting, please visit www.valuebasedobcare.com