Session 8 – Innovative Population Health Models: Advancing Value-Based Care in the M­­edicare Ecosystem

Amy Flaster, MD, MBA, Chief Medical Officer, ConcertoCare; Associate Physician, Brigham and Women’s Hospital; Instructor of Medicine, Part-Time, Harvard Medical School

Amy Flaster, MD, MBA, started her session with a discussion about the ongoing U.S. healthcare reform—a topic that remains top of mind and requires continued work in this country. Dr. Flaster shared the evolution of value-based care (VBC) innovations in Medicare, demonstrating how these changes help cut waste, empower beneficiaries, reduce provider burden, and more. She then walked through a proven case study on VBC innovations in Medicare for seniors built on both Medicare Advantage and Direct Contracting Entity (DCE) models.

Dr. Flaster presented on a multidisciplinary and comprehensive clinical approach including clinical, social, and behavioral support along with proprietary care pathways, virtual care technology, and advanced analytics. The clinical approach reduced patient hospitalization by 16 percent, readmission rates by 50 percent, and emergency department visits by 17 percent—all significantly better than national averages.

Dr. Flaster ended the session with three key messages:

• Change is needed: Costs are too high, and there is too much waste.

• Achieve the goals: DCEs will drive change by transforming risk-sharing arrangements, empowering beneficiaries, and reducing provider burden.

• Adjust to meet future requirements: The future of the Center for Medicare and Medicaid Innovation (CMMI) likely includes more mandatory models, a continuum of accountable care relationships, and a focus on equity.