Description

Episode Description:
In this episode, Rachel sits down with Josephine Wilton, Principal Consultant at Hullanta Consulting, to dive deep into the operational realities of implementing value-based care. They discuss the challenges organizations face in aligning data, staff, and financial models, and how smaller practices and solo practitioners navigate these complex systems. Josephine shares actionable strategies for bridging the gap between theoretical value-based models and real-world execution.

Rachel and Josephine had so much to cover that they'll be back next week to continue the conversation, exploring even more practical solutions and lessons learned from both providers and payers.

Timestamped Highlights:

1. 0:52–4:28 – Introduction of Josephine Wilton and her expertise in operationalizing value-based care.

2. 5:04–7:40 – Early contracting stages and the importance of communication between providers and payers.

3. 10:15–12:27 – Why operational and clinical teams must be involved early in negotiations.

4. 13:30–16:23 – Challenges faced by solo practitioners and smaller organizations in value-based care.

5. 18:32–21:36 – Importance of real-time data and the delays that can impact value-based programs.

6. 26:25–28:24 – Friction points in attribution, performance metrics, and total cost of care.

Key Topics Discussed:

• Value-based care models vs. fee-for-service systems

• Operational and clinical alignment during contract negotiation

• The critical role of real-time data in decision-making

• Challenges for small and solo practices

• Understanding total cost of care and outcomes measurement

Main Takeaways:

• Early involvement of clinical and operations teams is crucial to success.

• Real-time data access is necessary to track performance and guide decisions.

• Smaller organizations may have agility but require support with modeling and analytics.

• Clear communication between providers and payers prevents misalignment and frustration.

• Understanding both baseline and value-based payment structures is essential before execution.

Resources Mentioned:

• Implementing Value-Based Care, a Scoping Review

• Value-Based State-Directed Payments in Medicaid, Feb 2023–May 2024

• Why Primary Care Practitioners Aren't Joining Value-Based Care Payment Models

Connect with the Guest:

• Josephine Wilton, Hullanta Consulting

Connect with The Mental Health Evolution:

• Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast

• Instagram: @mentalhealthevolution

• LinkedIn: Mental Health Evolution

• Facebook: Mental Health Evolution

Music by Zach Harrison