The CEO of Alliance of Community Health Plans' opinion on 'Care Anywhere' and value-based care

Ceci Connolly is the president and chief executive officer at Washington, D.C-based Alliance of Community Health Plans. 

Ms. Connolly will serve on the panel "Top Priorities for Payer Executives Today" at Becker's Payer Issues Roundtable. As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the conference on Nov. 7-8 in Chicago. 

To learn more and register, click here.

Becker's Healthcare aims to foster peer-to-peer conversation between healthcare's brightest leaders and thinkers. In that vein, responses to our Speaker Series are published straight from interviewees. Here is what our speaker had to say.

Question: What are you most excited about right now and what makes you nervous?

Ceci Connolly: There are two lessons from the pandemic. First, 'Care Anywhere' works — people like it! Bringing care directly to people in their homes can be powerful. Whether it's telehealth, or home health care, meeting patients where they don't have to come to the doctor’s office or hospital is convenient. 

For example, as part of Hospital at Home programs offered by ACHP member plans, patients with complex diseases who required admission to a hospital only a few years ago can, and do, receive high-quality, acute care in the safety and comfort of their homes. Among our member plans, we have seen Hospital at Home reduce hospitalization rates, lower the cost of care per member and increase patient satisfaction.

Second, the pandemic showed that fee-for-service models aren't only ineffective: they're fragile. That gives me hope that we may see a real movement toward value-based models that promote quality of care. When providers were struggling because people stopped coming to the doctor's office, we saw firsthand that providers with capitated arrangements had long-term security and could remain focused on health rather than care. I'm optimistic more and more players understand that our industry has to move in that direction. 

I am nervous about the consolidation in the healthcare sector. A handful of behemoths have taken over a large portion of the U.S. health system, limiting consumers' choices and effectively monopolizing care and coverage. Researchers such as Zach Cooper at Yale and Leemore Dafney at Harvard have documented that consolidation leads to higher costs. Americans deserve options when it comes to their health care. 

Q: How are you thinking about growth and investments for the next year or two?

CC: At ACHP, we invest in our people, data and the payer-provider model. We have an amazingly resilient team that works hard to support our members' plans and goals. We invest in everything from highly tailored professional development to scenic, offsite staff retreats that get our creative juices flowing to keep our team healthy and inspired. As we represent our nonprofit regional plans, we are exploring opportunities to better serve them by diving deeper into analytics around the payer-provider model, which we believe offers the brightest future for our system. Marrying coverage and care makes sense, and ACHP exists to support successful payer-provider relationships to create better outcomes for everyone in our communities. 

Q: What will healthcare executives need to be effective leaders for the next five years?

CC: Everyone in healthcare needs to be willing to set aside antiquated notions of how the system used to function. The status quo is no longer appropriate, and the individuals who recognize that will be positioned to provide the best care and coverage available. The old models no longer serve our populations well — the emphasis needs to shift to focus on a value proposition. Healthcare leaders must be open to technology, non-physician clinicians, investment in primary care and investigations into social drivers of health. Leaders must concentrate on eliminating inappropriate, low-value services and moving away from expensive hospitalizations that often lead to complications. 

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