A02 – Creative Funding Strategies for Family-Based Models of Care: Payer and Provider Perspectives

Summary

Clinicians and payers alike have historically struggled to extend beyond patient-centered care to engage family members in ways that are meaningful, cost-effective, and efficient with use of time and staffing resources. As the healthcare system works towards the Quadruple Aim of healthcare reform, multigenerational and intergenerational healthcare models continue to show promise as key pathways to improve health outcomes, reduce total cost of care, improve the patient experience of care, and enhance the experience of providers and staff members delivering care. In this unique session, representatives from a regional health plan in Colorado, an independent practice association (IPA) in New York, and a pediatric healthcare program in San Francisco, come together to discuss current and cutting-edge methods of funding family interventions in both primary and behavioral healthcare. The presenters will first define intergenerational and multigenerational healthcare and provide key pieces of evidence that support family-based interventions’ effectiveness in meeting key outcomes such as reducing avoidable emergency department utilization (ED) and hospitalizations and improving condition-specific health markers, as well as sustaining long term positive outcomes. Presenters will showcase specific examples of how clinicians can connect family interventions delivered in their setting to high-priority goals within health plans, align family-based intervention outcome measures with high-value metrics, negotiate payer contract enhancements, and demonstrate a return on investment. The presenters will contrast how financial support for family-based interventions can be strengthened in both fee-for-service and alternative payment models. This presentation will include Q&A time, and participants will be invited to share lessons learned from their own experiences with measurement of and payment for family-based interventions. The session will close with a small amount of time allocated for large group discussion on next steps for measuring and financially supporting family interventions within attendees’ current practice contexts.