In this health care podcast, I speak with Steve Blumberg, VP of practice transformation for GuideWell Health, a subsidiary of GuideWell.
How’s this for an interesting career trajectory? Steve spent the last decade working on population health and value-based care delivery ... on the provider side. Recently, he transferred over to the payer side, working for GuideWell Health, which is the health services arm of GuideWell, which is part of a family of companies including Florida Blue. So, a payer, in other words.
I wanted to find out a bunch of things from Steve, but the main one is this: How do—if they, in fact, do—payviders improve care for patients? Or what does it take for an organizational structure to drive Triple Aim results?
Going into this conversation, here is what I was thinking about: Payviders have access to longitudinal data (potentially) that siloed entities will certainly not. They also have a goal to keep care affordable in a really real way, especially if the patient/member/client is on the ACA (Affordable Care Act) marketplace and shopping for premiums. My big concern with payviders, though, is whether they’re an “HMO in drag,” as they say.
On the other hand, payers and providers, in the most cynical sense, have wildly divergent goals. Search #medtwitter any day of the week—you will find a galaxy of tweets wherein doctors complain about payers—to just get a tiny sense of those wildly divergent goals. Do separate payers working with separate providers offer a kind of check and balance? A historical knock on this hypothesis is the inarguably crappy outcomes for chronic conditions that US patients have the privilege of paying comparatively ridiculous sums for. I couldn’t tell you whether those crappy outcomes are a result of the separateness of payers and providers or some other factor, but so it is.
Here’s the short version of one of Steve’s main points: It’s not about control. It’s about connection. It’s about being able to connect with patients over their continuum of care. It’s also about how consumers and employers are increasingly trading out choice and broad networks for an assurance of quality.
You can learn more at guidewell.com.
Steven Blumberg serves as vice president, practice transformation, for GuideWell Health. In this role, he is responsible for developing and implementing strategies for the further establishment of a high-quality, economically effective clinical system across Florida. He also provides guidance on value-based care and population health models.
Prior to joining GuideWell in June 2019, Blumberg served as vice president for value-based care at Baptist Health South Florida, where he led the strategy and implementation for Baptist’s population health and value-based care efforts. Prior to that, he was senior vice president and executive director of AtlantiCare Health Solutions, the New Jersey division of the Geisinger Health System, where he was responsible for population health, the organization’s provider physician group, and home care and hospice continuum services.
Earlier in his career, he was chief planning and business development officer at UHealth–The University of Miami Health System. Blumberg also held leadership roles at UF Health–Shands Healthcare and Baptist Health Jacksonville.
Blumberg has been active in community and professional organizations, including serving on the boards of the Ronald McDonald House, Community Hospice, and the Northeast Florida Health Planning Council. He has also served nationally on the Premier Population Health Steering Group and on the National Institute of Standards and Technology’s Baldrige Board of Examiners.
Blumberg holds a bachelor’s degree in business administration and marketing from the University of Florida and a Master of Business Administration from Florida State University. He is a fellow of the American College of Healthcare Executives.
03:30 How does thinking like a payer change the way you build out a primary care provider practice?
04:37 “When I was on the provider side, I definitely worried about the total cost of care … but making the products affordable was … someone else’s concern.”
09:12 How would you define practice transformation?
13:29 “We’re curating networks.”
16:56 “If they come to the market, they’ll be hard to ignore.”
17:38 How integrated is the physicians network?
18:35 “Control isn’t the right word … it is the connection with the patient … that’s where we think the most effective primary care takes place.”
18:59 Where does attempting team-based care fall apart the most?
21:25 Are employers trading out for an assurance of quality?