Lee A. Norman, MD, MHS, MBA, who spoke at The American Journal of Managed Care®’s Institute for Value-Based Medicine® event on population health March 9, 2023, in Kansas City, Missouri, discusses the shift to value-based care.
Lee A. Norman, MD, MHS, MBA, appeared at The American Journal of Managed Care®’s Institute for Value-Based Medicine® event on population health March 9, 2023, in Kansas City, Missouri, where he discussed the shift to value-based care. He served as the secretary of the Kansas Department of Health and Environment from 2019 to 2021 under Governor Laura Kelly. Norman, who served in the US Air Force and later as a colonel in the Kansas Army National Guard, is currently senior medical director for Optum Care Kansas City.
Transcript
What are some of the key considerations that health care providers need to keep in mind when transitioning to value-based care, and how can they ensure successful implementation?
Yeah, that's a great question. I think a number of things come to mind. One is that the fundamentals of good care have really not changed in a value-based care world. One, as we discussed last week, that evidence-based medical decision-making is critical. And it may sound obvious, but really, there's not a lot of evidence in some areas that we rely on clinical judgment, but where there is evidence for one pathway vs another one: really critical.
The second thing is very fundamental—shared decision-making. The day is here when we have honest and forthright discussions with patients: “This is a likely path that will get you there, this is one that's less likely and more invasive and could actually harm you.” So shared decision-making.
And then finally, I think it's really critical that in fee for service, which is where we've traditionally been practicing for years and years, it's not a matter of all of a sudden one day making a monumental shift to value-based care, where, among other things, there's compensation to the practice for having better outcomes, there's incentives being paid towards members of the health plans or patients—it's a hybrid model. And I think that physicians and other caregivers just need to get comfortable with the idea, it's not going to be a thunderclap where all of a sudden, at the stroke of midnight someday, that it goes from fee for service all the way over to value-based care. We have one foot in the boat and one foot on the dock, and we're having to kind of balance and get accustomed to value-based care.
Real-World Data Show Sotorasib Effective for NSCLC With KRAS Mutation
May 18th 2024Data from real-world and clinical-trial settings on frontline monotherapy treatment with the KRAS inhibitor sotorasib both show similar progression-free survivals and a high likelihood that the treatment’s efficacy is not affected with dose reduction.
Read More
CMS Medicare Final Rule: Advancing Benefits, Competition, and Consumer Protection
May 7th 2024On this episode of Managed Care Cast, we're talking with Karen Iapoce, senior director of government products and programs at ZeOmega, about the recent CMS final rule on Medicare Part D and Medicare Advantage.
Listen
Study Highlights Significant Increases in Utilization, Spending on DMD Drugs in Medicaid
May 17th 2024The findings add to recent research on the growing utilization, expenditure, and prices of Duchenne muscular dystrophy (DMD) therapies in the current landscape, an area health care policy could potentially address.
Read More
Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
Listen
Perioperative Nivolumab Boosts NSCLC Survival: CheckMate 77T Trial
May 16th 2024This interim analysis of the CheckMate 77T trial, outcomes were compared between adult patients receiving neoadjuvant nivolumab plus chemotherapy or neoadjuvant chemotherapy plus placebo for resectable non–small cell lung cancer (NSCLC).
Read More
ATS 2024: Bridging the Past, Present, and Future of Respiratory Care
May 16th 2024The application of artificial intelligence in medicine is anticipated as a highlight of ATS 2024, with sessions exploring its applications in research, radiological interpretation, and pediatric pulmonology.
Read More