Dr Katherine Schneider Says Adjusting to New Paradigm of Value Will Take Time

As the shift from volume-based care to value-based care continues, providers will require a whole new mindset and skill set to be successful, according to Katherine Schneider, MD, president of the Delaware Valley ACO.

What is the major challenge you perceive providers having as they adjust to MACRA?

Adjusting to MACRA, you know, I hate to keep using all the acronyms, I think the real question should be, what is the major challenge in providers adjusting to this move from volume to value, and moving towards taking on more risk for the outcomes of the population. And from a boots on the ground perspective, it really is a culture change, it requires a whole different way of taking care of patients, both on the clinical side and the business side, and we’ve got to allow for the time it takes for this massive change to occur.

So when I go out to most medical schools, residency programs, et cetera, everyone’s still being trained more or less in the old model of, you’re responsible for the patient that’s sitting in front of you, and providing good care to that patient from kind of the front door of your setting to the back door of your setting. These new models require a whole new skillset, and it’s like asking a surgeon to perform laparoscopic surgery when they’ve never used a laparoscope before.

So there really are new tools and techniques and a whole new mindset and skills that have to come into play, and that takes time. It is not something that you can just flip a light switch and suddenly you’re going to succeed in a value-based model just because you’re a good doctor or you’re a good hospital. It really is a new skillset and we have to teach it, and we have to recognize that people who’ve been successful in 30-year careers under a fee-for-service type model, it’s not just immediately applicable to the new world, and we’ve got to help them get there. And they want to get there.