Proliance Surgeons’ CEO discusses how value-based care delivers personalized, effective treatments for patients
The surgical practice joined Regence BlueShield’s Episodes of Care program in 2020
Better health outcomes, lower costs, higher patient satisfaction—value-based arrangements (VBAs) with health care providers deliver on the triple aim.
In 2013 Regence launched its VBA provider networks, partnering with health systems to drive greater provider collaboration to achieve more efficient and effective care. The work to date has achieved significant results, highlighted in Regence’s 2020 white paper “Where collaboration meets innovation.”
Building on this success, Regence recently announced its Episodes of Care (EOC) program in partnership with Signify Health, which specifically addresses care quality and costs for specific procedures. Health care providers who participate in the EOC program are paid for delivering improved patient outcomes and lower costs over a patient’s “episode of care”, which covers all the care a patient receives for a procedure or condition over a defined time period. This could include a knee replacement or delivering a baby, for example.
Proliance Surgeons recently joined Regence’s EOC program with a shared commitment to drive high-quality, cost-effective care. The surgical practice is one of the largest in the country, with more than 425 providers treating patients at more than 100 care centers in Washington state. Mark Barnhart, CEO of Proliance Surgeons, recently shared why the surgical practice joined the EOC program, how patients benefit from value-based care, and more. Answers have been edited for clarity and brevity as needed.
Why did Proliance choose to participate in the Regence Episodes of Care program?
We are fortunate to have an excellent group of 250 surgeons delivering exceptional outcomes while personally caring for each patient. During this exciting time in medicine, innovative solutions are at the forefront of patient-centered care. Proliance’s partnership with Regence BlueShield and Signify strengthens our position as a leader in outpatient surgery. The resources developed through this program will benefit our patients throughout the entire episode of care. For example, Proliance can expand services to include providing new telemedicine visits, nursing management and patient engagement systems. These improvements will allow us to remain in contact with patients, learn how they are recovering from surgery, and further enhance our market-leading delivery of outpatient surgery satisfaction and exceptional outcomes. Current and future patients will benefit as we work to improve their health care experience.
How do you think Episodes of Care and other value-based programs benefit your patients?
To provide the highest quality of care for patients, our surgeons consider all aspects of a case to deliver the best outcome for each person. This often includes recommending surgery for patients in one of our 18 Ambulatory Surgery Centers (ASCs), where improved patient safety and operational efficiency can be delivered at significantly less cost than a hospital outpatient department. That generally means substantial savings for both patients and insurers—along with a data-proven superior experience. For example, our surgeons find patients have a lower risk of infection, ER visits, or hospital readmission if they return home after surgery versus being discharged to a skilled nursing facility. Patients can safely have a personalized surgical experience in one of our ASCs and return to their home the same day.
Value-based arrangements support a comprehensive, holistic approach toward surgical care that begins 30 days before surgery and continues for months after the procedure. These programs support Proliance’s philosophy of personally guiding patients through their care experience. The Episodes of Care program provides our surgeons with outcome measures that are compared to national benchmarks, helping us continuously identify areas for improvement throughout the care episode. This is critical to furthering our mission of providing an excellent experience for the entire episode of care, rather than being limited to information from the day of surgery, readmissions, or infection rate data.
How does Regence’s EOC program align with the mission and vision of Proliance?
At Proliance Surgeons our mission is to be the leader in physician-managed health care services. Regence and Signify have recognized Proliance as a leader in surgical outcomes and asked our physicians to join them in improving the value of health care for their members. We are honored to partner with them in a program that supports our organizational values to provide excellent, high-value, clinical care.
The program aligns perfectly with our commitment to provide our patients with the right care, in the right location, at the right time. We believe the patient-physician relationship is the most important determinant in developing a patient-centered care plan that supports the needs of each person. Every patient deserves to have that relationship be the prime component of their care pathway. To have Regence honor that relationship, and collaborate with the physicians to manage these episodes, demonstrates a true partnership in care delivery and the innovation we value at Proliance. We are eager to work with Regence and Signify, and to learn from their engagements across the country, as we continually seek to improve the level of care our team provides to the most important element of any health experience: our patients.