Precision medicine initiatives link payer and provider

Precision medicine will find new application to population health initiatives, but those efforts are early in the development process.

Payers and health systems will increasingly work together to apply precision medicine findings to different population health models.

There’s still a ways to go, says Lili Brillstein, director of episodes of care for the market innovations division of Horizon Blue Cross Blue Shield of New Jersey.

“We’re at the beginning of the evolution,” she says. “At Horizon, the work we’re doing in New Jersey puts us ahead of the pack. We’re committed to making some of these changes—it doesn’t mean we have it completely right, but we just have to do it. They’re not going to be right or perfect from the beginning.”

Brillstein is responsible for the overall direction, strategy, design and oversight of the Episodes of Care/Bundled Payment Program. When she joined Horizon in 2013, the Episodes program was still in pilot and included only total hip and total knee replacement episodes. Since then, the program has grown to include additional orthopedic episodes, obstetrics and gynecology, GI, cardiology, and oncology. She also plays a leadership role in the advancement of Horizon’s PCMH, ACO and other value-based models.

Brillstein and co-presenter Andrew L. Pecora, MD, will discuss early opportunities for precision medicine-guided population health at a session beginning at 2:30 p.m. on Thursday, June 8, at the Institute and Expo of America’s Health Insurance Plans in Austin, Texas.

In their session, Brillstein and Pecora—president and physician enterprise and chief innovations officer at Hackensack Meridian Health—will explore how their organizations are applying precision medicine to population health models for oncology care.

Both organizations are working jointly on value-based models they have developed and implemented to ensure collaboration between stakeholders, to deliver customized care to patients who have cancer diagnoses and to achieve success among all pillars of the triple aim.

Quality outcomes are where some of the best returns on investment are found, Brillstein says. “We need to talk about all three pillars of the triple aim, and changing the spirit of the relationship between payers and providers. It’s what we attribute a lot of our success to.”

The session will include the release of quantitative results that reflect the evolutionary nature and process required for success, says Pecora, who is also professor of medicine and oncology at Georgetown University.

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