Physician leaders discuss how Permanente Medicine delivers value-based care

Though value-based health care exists in different flavors, the most successful recipe prioritizes preventive care, physician leadership, innovations that drive quality outcomes, population health management rather than episodic care, and collaboration between physicians, clinicians, primary care, and specialty care.

Speaking to the American Medical Association, 2 physician leaders recently summed up how Permanente Medicine is putting those ideals into practice. Richard McCarthy, MD, executive medical director of Mid-Atlantic Permanente Medical Group (MAPMG), and Stephen Parodi, MD, executive vice president of The Permanente Medical Group (TPMG), shared how Kaiser Permanente is delivering value-based care and in the process encouraging physicians to take the lead, help patients live longer, and find joy in medicine.

Where value-based care meets results

By focusing on prevention, value-based care reduces health risks, improves early detection, and increases overall care quality. This translates into significant improvements. At Kaiser Permanente of the Mid-Atlantic States, patients live 6 to 8 years longer than the national average. And Kaiser Permanente’s systemwide, long-term focus on high-quality care through population health management has helped improve Healthcare Effectiveness Data and Information Set (HEDIS) measures, such as in diabetes care and more.

“We’re in the top 5% for eye exams and kidney evaluations, top 10% for statin therapy, and top 25% for blood pressure control for patients with diabetes,” said Dr. McCarthy.

Related quality care story: Quality care: What it is and why it matters 

Innovating to provide industry-leading care 

From deploying AI to using predictive analytics, Drs. McCarthy and Parodi also shared ways that innovation permeates the culture of Kaiser Permanente.

To help reduce the administrative burden on the physician workforce, TPMG created a pilot program that deployed an AI ambient listening tool that transcribes notes during patient visits, allowing physicians to focus on patients more. This technology was soon rolled out to more than 25,000 physicians across Kaiser Permanente.

“The way that you can implement that kind of technology as quickly as we did is because we’ve got doctors talking to doctors,” said Dr. Parodi. “They are then co-designing what that AI product looks like, and then actually continuously improving it.”

Related ambient AI scribe story: Analysis: AI scribes save physicians time, improve patient interactions and work satisfaction

Dr. McCarthy noted that MAPMG is also regularly examining data to improve predictive modeling, care coordination, and remote patient monitoring. This process has helped reduce hospital readmission by around 10%.

Physicians can submit suggestions for improving processes, which can lead to testing and implementation of their ideas. “Every project we do is led by a physician,” said Dr. McCarthy. “If you submit an idea, you own it. You run the team. We give you the support and resources to make it work.”

Collaboration builds the foundation of effective value-based care delivery

Kaiser Permanente’s integrated model of value-based care, combined with innovations like these, ensures that all care teams and departments contribute to better prevention and patient outcomes across specialties.

“I’m a neurologist in practice, but my team schedules mammograms, colorectal screenings, Pap [tests],” said Dr. McCarthy. “We automatically order diabetes testing, and those results will go to their primary care doctor. If I see a patient with elevated blood pressure, follow-ups will be set up for them automatically.”

Momentum toward value-based care

Looking ahead, both physician leaders reiterated ways that value-based care represents a more sustainable model for addressing health care challenges, creating healthier outcomes and returning joy in medicine for the physician workforce.

“Again, the best solutions come from people doing the work,” said Dr. McCarthy. “I advise physicians to maintain balance in life, to have the discretionary effort to not only take care of patients but also think of the bigger picture of the population of patients they’re serving.”

“Value-based care for Kaiser Permanente and for the physicians who are practicing within the system has allowed us to drive toward better patient-centered outcomes,” said Dr. Parodi. “It has allowed us to collaborate as clinicians with each other, across geographies and across specialties, in a way that is very special and extremely fulfilling.”

Read the full AMA story with Dr. Parodi here and the story with Dr. McCarthy here.