On the Road to Value-Based Care: Operational & Cultural Change

While there can be no single roadmap for transitioning to value-based care, a panel session at the 2017 Cancer Business Summit, February 6-7, 2017, co-hosted by the Association of Community Cancer Centers, focused on Operational & Cultural Change that can help cancer programs move forward on the path ahead. Sarah Chavarria, Chief People Officer, NantHealth, shared that successful organizational alignment is centered around these key concepts:

• Strategy: mission, vision, and values; organizational goals; brand.

• Structure: placing the right talent in the right role; holding people accountable for meeting organizational goals.

• Talent: managing against a set of value-based competencies; assessing, developing, and growing the “best and brightest.”

• Rewards: creating incentives that drive collaboration to deliver on organizational goals; these incentives should be flexible in design to attract and retain top talent—in other words, identifying what your employees value so that the organization can package them and reward behavior they want.

• Systems and processes: these should enable decision making and responsiveness, and support effective execution.

“Cancer programs should create a ‘Deliberate Culture,’” Chavarria concluded. “If you are not deliberate in defining your culture, it will just happen; and it will not be what you want.”

Panelist James Grayson, a High Reliability Organization Specialist at West Cancer Center, outlined five key steps to help cancer programs succeed operationally and culturally:

Step. 1 Set your bar higher than everyone else’s.

Step 2. Hire people with potential.

Step 3. Invest in your front-line management team.

Step 4. Invest heavily in safety, risk management, leadership, and talent development.

Step 5. Be the cancer program your patients and staff need you to be.

Rounding out the panel was 2017 Cancer Business Summit Innovator Award Winner, Barry Russo, MBA, Chief Executive Officer, The Center for Cancer and Blood Disorders, who told attendees about the steps his cancer program took to move to value-based care, including:

• Centralizing patient intake from 9 practice locations to 1 location, streamlining and improving care coordination.

• Establishing triage as its own business unit.

• Implementing an internal case management program to facilitate proactive intervention and risk stratification of patients.

• Growing supportive care services (an effort that requires continual identification of new funding avenues), such as palliative care, chaplaincy services, nurse navigation, survivorship, etc.

• Implementing a new patient education program.

• Identifying technology gaps and improving decision-support around data and analytics.

• Developing communication tools around value-based care to share with employer and payer communities.

To help cancer programs prepare for the change to value-based care, Russo offered five high-level takeaways:

1. Deliver a consistent message; identify the changes needed and understand how to make these changes.

1. Establish a new norm—while still a physician-centric care delivery model, ALL members of the care team are essential to healing lives after cancer. Value-based care requires cultural change and significant organizational re-engineering.

1. Understand that staff and clinician education is a journey and not a destination. Accept that leadership must focus on education, re-education, and then more education. Effective team building requires repetition—leadership rounds, nursing forums, regular reports from pillars in the cancer program, etc.

1. Be aware that nursing needs a hyper-focus. Nurses enjoy the most touch points with patients, so nursing stability is of the utmost importance to successful cancer programs.

1. Build strong teams at EVERY level of the organization; teams that can process constant change. The move to value-based care is not for the faint of heart. Staff must be able to accept feedback; brutal honesty is essential to the process. Staff must accept that the move to value-based care means change is interrupting their day, not making it easier.

Learn more about what lies ahead for value-based care at the ACCC 43^rd Annual Meeting CANCERSCAPE, March 29-31, 2017, in Washington, D.C. Join your peers to hear from leading experts and decision-makers about the evolving healthcare policy landscape, the latest on alternative payment models, data collection and quality measures, and more. Explore the meeting agenda here.