Many roads will bring us to health value, but some roads will get us there faster than others. As we reimagine our nation’s healthcare system, we must build alternative avenues to value beyond the conventional fee-for-service approaches to transformation. In building a superhighway that fully unleashes the power of independent and accountable physician groups, we will produce faster and better results.
Joining us this week on the Race to Value is Susan Dentzer, the President and Chief Executive Officer of America’s Physician Groups (APG), the organization of more than 335 physician practices that provide patient-centered, coordinated, and integrated care for patients while being accountable for cost and quality.  APG members provide care to nearly 90 million patients nationwide and are leading this nation’s superhighway in the race to value.
In this podcast episode, we discuss advanced primary care transformation, restructuring of payment models to reach scalability and impact, health policy reforms, PCP employment trends, the M&A landscape in provider consolidation, Medicare Advantage, and the power of tech-enabled asset-light care delivery.

Episode Bookmarks:
01:30 Introduction to Susan Dentzer, President and Chief Executive Officer of America’s Physician Groups (APG)
04:30 More than 60% of health care payments in 2020 included some form of quality and value component
05:30 Despite traction, moving to value at a glacial pace (reference recent surveys fromMGMA and HCP-LAN)
06:30 Susan discusses the entrenchment of FFS and how difficult it is to change the payment edifice in U.S. healthcare
09:00 Overcoming the extraordinary backlash and resistance to realigning payment incentives in American healthcare
12:00 How APG is approaching the national transition to value
13:30 The need for advanced primary care in helping CMS achieving its 2030 goal to drive accountable care
14:45 The systematic undervaluing of primary care and overemphasis on hospitalizations
16:00 How the payment structure was hijacked by proceduralists and specialty care
16:30 Clinton era health policy reforms that attempted to restructure Medicare payments to primary care
17:30 Where would we have been if we tackled primary care reimbursement and workforce challenges in the 1990’s?
18:30 Limited progress in voluntary innovation models to advance primary care effectiveness (e.g. PCMH, team-based care)
19:30 How the NHS in England created state-of-the-art primary care through 24/7 access
20:45 The private sector stepping up to modernize care delivery access and infrastructure where public policy failed
21:30 Investment in primary and secondary prevention to address chronic disease
22:00 Transitioning from a cottage industry to a well-funded, risk-based primary care strategy to improve population health
24:00 PCP employment by hospitals often not an driver of value-based care due to referral maximization objectives
24:30 Independent PCPs will need to find investment partners to advance risk-based transformation
24:45 Susan discusses the success of Central Ohio Primary Care’s partnership with agilon health
29:00 Medicare Trust Fund solvency will be depleted by 2026, but APM adoption could help avoid this fate.
30:30 “Many roads can bring you to value, but some roads will get you there faster than others.”
31:00 MACRA legislation created MIPS and APMs using the current fee-for-service chassis
31:45 The importance of the 5% bonus/incentive payments to QPP participants that are a part of Advanced APM models
32:30 Hospitals pocketing APM incentive payments for employed providers will not accelerate path to value.
32:45 Results comparison between physician-led and hospital-led ACOs
34:00 Susan explains why America’s physicians are the superhighway to Value Transformation
36:00 Capitation within the ACO REACH model as a continuation of full-risk success in Medicare Advantage
38:00 “Alternative avenues to value – beyond the conventional F...

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