“EP202: The P&L of Value-Based Care, With Frazer Buntin, President of Value-Based Services at Evolent Health”
by Stacey Richter

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As a broad stroke, value-based arrangements produce better patient outcomes than fee for service. Health care businesses, like all other businesses, are rational actors when it comes to the economics of their business models. So when it comes to value-based care, the business case for moving forward needs to be clear and present. My interest in this is the mission of this podcast—to see patient outcomes improve in this country so we move from #34 on the WHO billboard charts to at least the top 10 as a modest goal. Today I speak with Frazer Buntin, president of value-based services at Evolent Health and a noted expert in how to actually achieve value-based incentives and make CFOs happy, because CFOs need to be happy for patient outcomes to improve meaningfully at the system level and at the national level.

You can learn more at evolenthealth.com.

Frazer Buntin has worked in strategic and operations leadership positions for the past 17 years and currently serves as the president of value-based services for Evolent Health. Evolent Health partners with leading provider organizations to achieve superior clinical and financial results in value-based care, actively managing care across Medicare, Medicaid, and commercial and self-funded adult and pediatric populations. Frazer is responsible for managing the operational performance of Evolent Health’s partners.

Prior to Evolent, Frazer served as CEO for WhiteGlove Health, a population health management firm providing primary health care services to self-insured employers and health plans. Previously, Frazer was co-founder, president, and CEO for Silvercare Solutions, one of the largest providers of primary care and health care management services to the senior population in the United States. Prior to Silvercare, he served in several senior-level roles for Healthways Inc. and Dollar General Corporation. Frazer currently serves on the board of Leadership Health Care and holds an MBA from Vanderbilt University and a BS degree from The University of the South.

01:39 How the strategy of holding on to fee for service (FFS) in health systems is very risky.
03:17 How a value-based care (VBC) model can build clinical integration.
04:18 Why clinical integration isn’t really happening with an FFS model.
05:07 Are better patient outcomes the proxy for value-based care?
06:14 “If you define value in health care as cost over quality, and you don’t change the quality at all, but you lower the cost, you’re still increasing health care value.”
08:37 “You can define quality as a reduction in patient admissions.”
11:54 Reducing practice variability.
13:35 The factors to include in shared savings and the cost side of health systems and physician groups.
14:41 “What does it cost to go achieve those shared savings?”
17:05 The challenges of switching from FFS to VBC.
17:30 “People will tend to default back to what they know, and what they know is fee for service.”
18:04 Who pushes VBC through, when it’s easier to revert back to FFS?
20:07 Sacrificing the short term for the long term.
21:45 Frazer’s estimated timeline for when value-based care will tip the scales on fee for service in terms of reimbursement and profit.
24:29 Are there areas where reducing unnecessary costs align in both FFS and VBC?
28:10 “The level of innovation when people get on board is just stunning.”
31:15 Evolent’s role in this transition in care models.
31:42 “We help health systems that are ready to move.”

You can learn more at evolenthealth.com.

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