C.J. Stimson, MD, JD, presented “Alternative Payment Models: Value Care Bundling” at the 6th International Bladder Cancer Update on November 19, 2022, in Scottsdale, Arizona.
How to cite: Stimson, C.J. “Alternative Payment Models: Value Care Bundling” November 2022. Accessed Nov 2024. https://grandroundsinurology.com/controversies-in-nmibc-guidelines-and-beyond-2023/
Alternative Payment Models: Value Care Bundling – Summary
Cary (CJ) Stimson, MD, JD, Chief Medical Officer of the Vanderbilt University Medical Center Employee Health Plan, discusses value care bundling as a method to improve the healthcare landscape, why it is important, and how it could be leveraged to drive value for patients and physicians. He states that the fee-for-service model discourages physicians from having a patient-centric approach. Historically, value based care is based on the idea that value equals outcomes divided by the spend required to achieve them. He mentions the AUA Choosing Wisely campaign, which is an effort to identify value in practice. Dr. Stimson comments that low value care is instinctively recognizable in practice. He describes value based payment as a bet on yourself, and that it’s important to chase value-based payment to improve the health care experience. He expands on the cost of healthcare in the United States and that an estimated 30% of that cost is waste. To implement value-based care, Dr. Stimson says it is important to get the delivery model correct prior to moving on to the payment mode. Next, he explains the concept of a bundled payment model, where the patient would pay one price for a healthcare-related event instead of paying separately for each service. He notes that Medicare has implemented some bundled payment models in the past, and that it places the monetary risk for high-cost care on the provider, not the patient. In one instance, implementing this model led to a lower readmission rate and less spend overall. He concludes by stating that there are movements towards value based payments and it is important to be prepared to implement it in the future.
About the 6th International Bladder Cancer Update:
The International Bladder Cancer Update (IBCU) is a CME conference focused on the diagnosis and treatment of bladder cancer. The conference offers medical professionals an opportunity to listen to updates from, and interact with, expert international faculty to improve knowledge and determine best treatment practices to improve patient outcomes. IBCU encompasses expert lectures, interactive discussions, a panel roundtable, debates, and case presentations. It is physician-led, multi-supported, and designed for urologists, urologic oncologists, and other healthcare professionals involved in the treatment of bladder cancer.
For further educational activities from this conference, visit our collection page.
ABOUT THE AUTHOR
Cary (CJ) Stimson, MD, JD, serves as the Chief Medical Officer of the Employee Health Plan , Senior Vice President of Value Transformation in the Office of Population Health, and as an Assistant Professor of Urology at Vanderbilt University Medical Center (VUMC) in Nashville, Tennessee.
In these roles, Dr. Stimson is facilitating VUMC’s transition to a value-based purchaser and provider of healthcare services. He is accountable for a wide portfolio of initiatives, including VUMC's governmental, commercial, and direct-to-employer bundled payment programs and provides clinical leadership to the Vanderbilt Health Employer Solutions team. In addition, he provides insight and guidance to the Vanderbilt Health Affiliated Network’s (VHAN) value agenda.
As CMO of the VUMC employee health plan, Stimson brings his creativity and experience leading to transformative, value-based programs that ensure the 44,000+ EHP members receive the best outcomes and experiences for their healthcare dollar. Dr. Stimson’s expertise in value-based care developed during the four years he served as a Senior Advisor at the Center for Medicare and Medicaid Innovation.
Dr. Stimson is a practicing cancer surgeon specializing in the surgical treatment of urologic malignancies, particularly kidney, bladder, and prostate cancer. He received his medical and law degrees from Vanderbilt University and completed his residency in urologic surgery at VUMC. He completed a fellowship in Urologic Oncology at The Johns Hopkins Hospital in Baltimore, MD.
