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Value-based reimbursement models require different leadership to align the practice and move it forward around a team-based model of care.
A change is occurring, and it’s not the type of change we typically talk about in the shifting healthcare landscape. It is a change requiring us, as healthcare leaders, to acquire new skills, talents, and capabilities as we lead new and expanded teams of people in the treatment of patients.
Physician leaders, in particular, are trained well to do many things. We perform highly technical skills and complicated procedures. We manage multiple needs at the same time. We take an unstructured human narrative, break it down into individual components, and develop an entire care plan-determining if and when others are needed. We are trained well for one-to-one interactions with our patients. This training has made us very good at a certain type of leadership-one that is based on hierarchy and a top-down approach.
Unfortunately, this team dynamic and leadership style is not effective in a value-based reimbursement model, where better health outcomes for chronically-ill patients is the measure of success.
As physicians, we intellectually understand a team-based approach is needed. We recognize the need for an array of skills and capabilities like cardiology, physical therapy, behavioral health, social work, nutrition, etc., but we have not successfully incorporated these skills and capabilities into a better process to care for populations of people. We have generally not integrated social determinants of health or social workers, or recognized the true need of behavioral health as part of physical health.
New style needed
Over the past decades, we’ve expanded whom we work with, but we haven’t fundamentally changed how the team functions to best support the care of the chronically ill. For people to work together differently, we need a different style of leadership.
Research from the NHS Institute for Innovation and Improvement shows that clinicians want to be led by clinicians. If physicians want to lead in the value-based world, we need to get a team working together to achieve something that’s superior to what we would have achieved on our own. How do we do that?
Ultimately, the goals of healthcare are still the same. Our job is to improve health outcomes and help people achieve their best health. To do that, we must work together in new ways and, as leaders, we must change the way we lead.
Roy Beveridge, MD, is a Managed Healthcare Executive editorial advisor and Humana’s chief medical officer. Meredith Williams, MD, MBA, is lead medical director.