If anyone knows a thing or two about healthcare transformation, it’s Adam Boehler. Over the years Boehler has worn many hats, from founding Landmark Health, serving as Deputy Administrator for Centers for Medicare & Medicaid Services (CMS) to his most recent role as Chief Executive Officer for the United States International Development Finance Corporation. Today Boehler is the CEO at Rubicon Founders, an entrepreneurial firm in Nashville, Tennessee dedicated to helping build and grow transformational healthcare companies.

Boehler recently sat down with Health System 100 to talk about the post-COVID healthcare outlook. Throughout the interview, Boheler covered the following topics:

  • How COVID-19 has changed the environment for healthcare providers
  • Where healthcare policy and Medicare Advantage plans are headed
  • Providers’ risk and opportunity from Private Equity-fueled healthcare disrupters

The New World of Care

The onset of COVID-19 has changed the way many people receive care, and Boehler spoke to the fact that some of these changes have been extremely beneficial. Telemedicine is the one of the biggest ways healthcare has changed, with telehealth visits accounting for approximately 30% of total outpatient visits early in the COVID-19 pandemic, according to research published in Health Affairs. Many providers today are trying to streamline how to continue offering and improving these services for the foreseeable future.

Another area of care that has improved is the ability for more people to have access to COVID-testing sites. Whether it’s at a CVS or a traditional doctor’s office, more locations are popping up across the country which allows patients to have earlier diagnoses and treatment options in place.

Lastly, Boheler praised the changing definition of a hospital. No longer does an acute care center have to have walls. People can receive care in their homes or wherever they wish. CMS’s Hospital Without Walls program, which began in March of 2020, is a great example of hospitals providing service to eligible patients in the comfort of their own homes.

The Future of Policy & MA Plans

With a new administration comes questions about current policies and the future of Medicare Advantage Plans. Boehler emphasized that while it’s still very early to tell how regulation will unfold, CMS remains committed to their goals: to reduce cost and improve quality.

Boehler touched on the Geographic Direct Contracting Model, which is a new payment and service delivery model being tested by CMS. The purpose of this model, nicknamed Geo, is to determine whether a geographic-based approach to care delivery and value-based care can improve health and reduce costs for Medicare beneficiaries across an entire geographic region.

Advocates believe that Geo could help to strengthen integrated relationships with healthcare providers and community organizations in a region to better coordinate care and address SDoH for Medicare beneficiaries. Boehler proposed that while this could be very positive for patients in terms of lowering cost, it’s important to make sure that quality of care isn’t being compromised.

Providers’ Risk & Opportunity

Boehler concluded the interview talking about the opportunity providers have to take risk while improving the patient experience. He reiterated the importance of systems not trying to be all things for all people, and to focus on “being bold” in their areas of specialty. By staying true to their mission, providers have the best opportunity to make a lasting positive impact on their respective communities.

Click here to view Boehler’s full interview.

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