Catalyst for Payment Reform

Stephen Furia on Mount Sinai’s Principles of Success for Direct to Purchaser Relationships

Stephen Furia on Mount Sinai’s Principles of Success for Direct to Purchaser Relationships

CPR’s Program Director, Andréa Caballero, chats with Stephen Furia, Senior Vice President, Population Health at Mount Sinai Health System, one of the largest health systems in New York. The Population Health division is the business unit within Mount Sinai that works directly with employers and other health care purchasers, providing an array of services including primary care focused near-site health centers, Centers of Excellence arrangements for specialty care, executive health programs, and, more recently, assisting employers in responding to the COVID-19 pandemic.

Reflecting on the Mount Sinai’s five years of partnering with those who pay for health care, Stephen offers a set of principles that illustrate how the health system has successfully achieved maximum value in its direct to purchaser partnerships. Those principles are:
• Investing more in primary care;
• Referring to high-value providers for specialty care, when necessary;
• Aligning incentives to promote value;
• Encouraging healthy competition among providers in a given market.

Listen in to hear Stephen’s explanation of what these principles look like in action for Mount Sinai as it delivers a transformed health care experience to its more than 40 purchaser clients.

For starters, the health system’s primary care offering incorporates navigation and care management services to accompany patients from symptom onset to end of treatment and takes a holistic approach to disease prevention. Sound familiar to the models of others like Iora Health and OneMedical? That’s not a coincidence, according to Stephen- these best practices have been adopted throughout the country, marking a move away from away from the disaggregated model of multiple niche vendors filling in the gaps and moving to a broader definition of what high-value primary care entails.

In the conversation, Stephen Furia emphasizes how benefit managers play an important role in the success of care delivery transformation. A provider like Mount Sinai may be more willing to take on financial risk in an arrangement where the employer has specific tools in place, such as communications to make employees aware of the offerings and benefit design that makes primary care an easier and cheaper options for patients to access. Finally, Stephen reiterates a resounding truth about transforming care delivery: no one can do it alone. For Mount Sinai, that means collaborating with not only the purchaser itself – to understand the purchaser’s specific needs and pain points, but with the purchaser’s advisors and health plan administrators as well.

Ready to learn more about direct contracts between health systems and employers? Check out CPR’s Direct Contracting Get Started Brief.

This interview is part of CPR’s work to understand whether group purchasing efforts can secure better health care value for employer-purchasers. Funded by the Commonwealth Fund, CPR is assembling insights into the forces that can facilitate or hinder purchaser efforts to amass volume.

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