EmblemHealth’s Ignagni talks advantages, challenges of value-based health care
Like many industry leaders in the world of health care, Karen Ignagni expresses optimism about the ongoing transition from volume-based to value-based medical payments.
“Once you make a commitment as an organization to move from a fee-for-service-based, body-part-by-body-part reimbursement to something that’s more holistic, where you’re sharing incentives with providers, they become your partners,” said Ignagni, the president and CEO of EmblemHealth, in an interview with City & State Senior Editor Jon Lentz. “So suddenly you move from the opposite side of the table to the same side of the table.”
But Ignagni, who joined the New York-based health insurance company a year ago, acknowledges that obstacles remain.
“The largest obstacle is that there’s a continuum of ability to accept risk on the part of a provider, whether we’re talking about a physician, a physician practice or a hospital,” Ignagni said. “So do they have the ability to maintain and manage risk, to be in that different kind of financial arrangement where they are now working with us to achieve specific objectives, and they get the benefit of that. But if they don’t meet the objectives, they also have a downside risk.”
The way to address those risks, Ignagni said, is to help doctors and hospitals they partner with, primarily by sharing useful data.
“We can help our clinical partners know that a particular individual is at risk for not having had her feet checked, if she’s diabetic,” she said. “I may be at risk of not having a mammogram because I’ve just put it off, year after year. So things of that sort, we can play a very important partnership role … with our clinical partners to make sure we’re providing support, we’re providing care coordination, we’re providing data to them, so that we help them on this journey as we all make that transition together.”