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Introduction |
| A discussion with Dorothy DeAngelis, Wayne Gibson and Gerry Meklaus about the convergence model. |
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Q&A |
Q: Why have you chosen to build a team, Convergence Solutions, using a multidisciplinary approach rather than sector or service specific?
A: (Dorothy DeAngelis) From my perspective it’s because regulatory (ACA) and market driven forces have combined in an interesting way to have payers, providers, life sciences companies converging to provide value-based care.
The traditional fee for service system was simply not sustainable. The industry was headed in this direction regardless of legislation. As a result, many new payment models have been implemented to share the risk associated with patient care.
This evolution in the industry has also led to an increase of M&A activity in certain sectors and collaborations or partnerships in others. Entities from different sectors of the industry are finding themselves having to work together more efficiently. The dilemma is to put together a system that truly works effectively to improves patient outcomes and reduce costs.
Operating in this fashion is not easy. It requires technology & analytics, clinical integration, quality and cost measurement, legal & governance, financial reporting, and physician engagement. In an M&A or collaborative situation these systems must be carefully reviewed to capitalize on key synergies.
I believe we have to understand the full healthcare landscape in order to be effective problem solvers in the new healthcare environment.
(Wayne Gibson) The multidisciplinary approach really mirrors how our clients are transforming to address the new landscape. For example, providers are learning and developing new competencies such as effectively managing risk-bearing contracts and payers are starting to directly invest in and acquire providers and must learn how to effectively incentivize clinicians with different types of contracting arrangements to maximize both quality of care and the value of risk-bearing contracts.
This presents a challenge to our clients, but there exists strong market opportunities for those who can develop the necessary competencies and transform their business.
(Gerry Meklaus) This approach allows FTI to offer deep cross-capabilities in the key areas that are fundamental to success in value-based contracting and medical management. Through this collaboration, we will offer our clients deeply experienced individuals who have “been there and done that”, thereby accelerating our clients’ successful transformation and taking some of the risk out the inevitable learning curve. We will also offer tools and analytics that would take our clients a long time to develop on their own. Because most “converging” entities are by definition entering into new businesses, they may not even know what tools and capabilities they need for success until they have “done deals” and painfully discovered what they didn’t know. We can offer our clients the experience to identify those gaps and fill them quickly, before losses accumulate and stakeholders begin to sour on the deal.
Q: What is Convergence Solutions?
A: (DD) Our solution was to build a team of professionals with a proven track record in each of these areas, both sectors and services. The multidisciplinary approach allows us to attack a problem using various perspectives. It also provides a check-and-balance system to ensure all things are considered.
More importantly, our broader knowledge base enables us to identify and implement solutions faster to turn our client’s risk into opportunity.
(WG) It’s an interesting term – we wanted to express the concept that these diverse skillsets and competencies were coming together in our practice to mirror what is occurring in the industry; however, we also wanted to convey a sense of momentum and direction.
We see this as the direction the industry is heading and for many industry participants this will feel forced upon them – some providers may not be prepared to emulate payers and vice-versa, but the industry is converging and our clients will need to be prepared to change either by directly growing their own competencies or selectively collaborating with others when the opportunity makes sense.
We recognized that providing the right solution for our clients increasingly required individuals from various aspects of our practice (e.g. clinical experts, data experts, risk modeling experts, contracting experts) to closely collaborate; therefore, convergence was already occurring within our own business – the creation of a convergence practice formalizes what we were already doing to serve our clients.
(GM) The convergence concept is meant to convey the necessary confluence of all players in the healthcare system around the delivery of greater value. This seismic shift, away from piecemeal services and fragmentation, and towards more integration, originated in the “Triple Aim” concept promulgated by Don Berwick and others. But it has taken hold as a result of the Affordable Care Act as well as employers and patients demanding lower costs and higher quality, simultaneously. We believe this shift is a true pivot point in healthcare delivery and financing in the US, and in some way will affect everyone. FTI offers our clients a thoughtful and profound set of solutions that enable all players to nimbly adapt to this transformative shift and avoid unexpected negative financial implications of this change.
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