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What's Taking Place in the Private Sector of Value-Based Payment? Francois de Brantes Explains


In this final video of a four-part video series, Signify Health senior vice president of Episodes of Care, François de Brantes, speaks with Managed Healthcare Executive about value-based care, the toxic incentives in healthcare, how the Direct Contracting Model differs from Medicare Advantage and more.

Below you'll find a brief excerpt from the transcript of our recent podcast interview with François de Brantes. They have edited for clarity and length.

What is going on in the private sector as far as value-based payment is concerned?

I'd say that the single biggest continuous thrust that we're seeing in the private sector, and it harkens back to my early days in the industry is encouraging, on demand side, plan members to seek out the best care that they can get in their local, local community, at the most reasonable price, what we call, you know, value. That can happen in the private sector, because private sector employers have the ability to do steerage. And steerage can take multiple forms. And what's really exciting is that this combination of member incentives to encourage employees to go seek care from the higher value providers with payment reform that binds those providers in risk contracts.

Related: Is the Direct Contracting Model Similar to Medicare Advantage? Francois de Brantes Has Our Answer

We do this with a number of payers across the country and directly with one large employer, the state of Connecticut employee plan. And what we're finally seeing I think a lot of us knew could happen if you brought these elements together, which is actual competition for value in health care by providers who are willing to take on accountability for the management of patients, and willing to compete based on the combination of the quality of the care that they deliver, and the price that they're willing to charge for that care.

So I think if you had asked me a few years ago, I would have said, yes, theoretically, we are pretty sure this can happen at scale, because there's enough micro-experiments that have been done that show that it can And today, I can see it absolutely does work. There's no question or doubt it can work because we were seeing it work every day. And now, the task is how do you scale this? How do you bring it to 20 markets across the country so that people start believing, because they're seeing it in action, as opposed to conceptualizing it and hoping for the best.

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