Courtney Fortner: Leading the Charge for Value-Based Care at Navvis

In the ever-evolving landscape of U.S. healthcare, the question of whether value-based care remains the right strategy to reduce costs is more pertinent than ever. As the President and Chief Executive Officer of Navvis, Courtney Fortner stands at the forefront of this critical discussion, advocating for a healthcare model that prioritizes patient outcomes over volume of services rendered. With healthcare costs projected to rise by 7.0% in 2024, Fortner’s insights into value-based care are not just timely; they are essential for shaping the future of healthcare delivery.

The Current State of Healthcare Costs

The healthcare industry has been grappling with rising costs for over a decade, with annual increases consistently exceeding 5.5%. Despite the theoretical appeal of value-based care—where providers are compensated based on patient health outcomes rather than the quantity of services provided—real-world implementation has yet to yield the anticipated reductions in spending. Recent Congressional hearings have scrutinized the Centers for Medicare & Medicaid Services (CMS) Innovation Center for its inability to generate significant savings, raising questions about the efficacy of value-based care as a strategy.

However, Fortner argues that the focus should not be on abandoning value-based care but rather on enhancing its execution. "We must refocus our efforts on supporting healthcare providers and systems in this transition," she asserts, emphasizing the need to avoid reverting to outdated fee-for-service models that have historically failed to control costs.

Defining Value-Based Care

At its core, value-based care is a healthcare delivery model that incentivizes providers to improve patient health outcomes while reducing the severity of chronic diseases. When implemented effectively, this model can lead to remarkable results. Fortner’s leadership at Navvis has demonstrated this potential through impressive metrics:

• Consistent achievement of 4.5 to 5.0 Star quality ratings over the past six years.
• Patient satisfaction scores ranking in the top 20% nationally.
• Average Medicare spending per capita 25-30% below the national average for six consecutive years.
• Physician satisfaction, as measured by the AMGI Survey, ranked above the 95th percentile in professional fulfillment.

These outcomes suggest that value-based care, when executed correctly, can enhance quality, patient satisfaction, cost-effectiveness, and physician well-being. The pressing question, then, is not whether value-based care is the right strategy, but how to implement it more effectively.

The Right Strategy for Healthcare

Fortner identifies three primary strategies to curb the rise in medical spending:

1. Shifting Costs: This approach involves transferring financial burdens to families and employers, effectively pricing them out of the market.

2. Rationing Care: By paying providers less, this strategy aims to artificially cap spending, which can lead to reduced access to necessary care.

3. Accelerating Value-Based Care: Fortner advocates for improving the execution of value-based care to achieve better outcomes with fewer resources.

Given the lack of political will to pursue the first two options, the focus must remain on enhancing value-based care. Fortner highlights that up to 30% of U.S. healthcare spending is wasted on low-value care, which includes administrative complexities, duplication of services, and overutilization. Addressing this waste is crucial for the success of value-based care.

Activating Value-Based Care

To transform the primary care business model and realize the full potential of value-based care, Fortner emphasizes several critical strategies:

1. Standardization and Automation: By removing variations in care delivery and automating administrative tasks, healthcare providers can improve quality and efficiency. This approach alleviates the administrative burden on physicians, reducing burnout and enhancing job satisfaction.

2. Managing the Unseen Patient: In value-based care, it is essential to manage not only the patients who visit the office but also those who are attributed to a provider but may not be receiving adequate care. Identifying and managing these patients can lead to improved outcomes and cost control.

3. Shifting to Asynchronous and Virtual Platforms: Fortner advocates for a shift away from traditional in-person visits for low-acuity conditions. By utilizing asynchronous communication and virtual care platforms, healthcare providers can extend their reach and improve access for patients while using resources more efficiently.

4. Aligning Volume and Value Strategies: A dual approach that aligns volume-based and value-based strategies, particularly in acute and inpatient settings, is essential for optimizing care delivery and ensuring financial stability for health systems.

The Path Forward

Transforming a complex system like healthcare is a gradual process. Fortner acknowledges that significant changes often take a decade or more to fully realize their benefits. The key to success lies in addressing the concerns of physicians and providers, ensuring they have the support and resources necessary to thrive in a value-based model.

Moreover, Fortner emphasizes the importance of partnerships with organizations that specialize in managing change and delivering operational excellence. These collaborations can provide the expertise and resources needed to navigate the complexities of value-based care implementation.

Conclusion

As healthcare costs continue to rise, skepticism about the efficacy of value-based care persists. However, Courtney Fortner’s vision for a transformed healthcare system underscores the importance of commitment to this model. By focusing on improved execution, leveraging successful strategies, and supporting healthcare providers, the industry can overcome current obstacles and unlock the full potential of value-based care.

In a landscape where the alternatives to value-based care—such as cost-shifting and rationing—are fraught with challenges, Fortner’s leadership at Navvis represents a beacon of hope. The path to value-based care may be challenging, but it remains the most promising strategy for enhancing healthcare quality while controlling costs. As stakeholders across the healthcare spectrum recommit to this vision, the opportunity to create a more efficient, patient-centered system is within reach.