“Quality over quantity” is an adage many live by.
The American healthcare system? Not so much.
Payformance Solutions is trying to change that. It’s developed technology that makes it easier to move away from the traditional fee-for-service healthcare payment model and toward the quality-focused “value-based care” model.
The aim of value-based care is to improve quality while lowering costs.”
Bringing change to the healthcare industry doesn’t happen overnight, which is why Payformance places a big emphasis on hiring people who are truly passionate about its mission.
“That’s what allows us to keep each team member engaged and highly effective,” said CTO Kevin Mehta. “Each team member is a subject matter expert for their own content area.”
We recently spoke with Mehta to learn more about the healthcare industry, Payformance’s tech and what he looks for when hiring.
What is value-based care, and why is it important?
The fee-for-service payment model, currently the most popular payment method in the United States, is where each medical service is paid for separately. In value-based models, providers and hospitals are paid for the quality of their service, based on the health outcomes of their patients. The aim of value-based care is to improve quality while lowering costs.
The current model is unsustainable. Healthcare spending is nearly 20 percent of the U.S. gross domestic product. But for providers and health systems that can’t adjust to the new model, the financial penalties and lower reimbursements of value-based care create a significant financial burden. And right now, the majority of payers and providers negotiate value-based care contracts with incomplete information and confusing tools with unclear insights, leading to a misguided understanding of the terms of their deal.
You bridge that gap through your flagship platform, TrustHub. What benefits does your platform provide?
TrustHub makes value-based contracting negotiations easier, transparent and scalable, which incentivizes the industry to positively engage in an ecosystem that ultimately leads to better healthcare outcomes for the patient at lower costs. TrustHub provides payers, providers and employer groups with a low barrier to entry by operating outside the legacy fee-for-service healthcare IT systems, which have largely remained the same for the last 30 to 40 years.
The Michigan Association of Health Plans is an early adopter of TrustHub. Could you elaborate a bit on how healthcare professionals actually use your platform?
Working within our platform, payers and providers are sharing data and have a mutually transparent view of their retrospective performance utilizing our proprietary episodes-of-care analytical engine. Their costs and quality metrics are no longer one-sided, enabling them to design, develop and monitor mutually beneficial contracts leading to increased revenue for the payers and providers, improved outcomes for patients and stabilized costs.
What are Payformance’s top priorities this year?
Our top priority for 2018 is growth: the growth of TrustHub, of our client portfolio and our team.
Speaking of growing your team, what do you look for when hiring?
We hire inquisitive, detail-oriented and passionate people. Everyone at Payformance is passionate about some aspect of the company: infrastructure-as-code, security, analytics, healthcare, data models, design, data visualization, and so on. That’s what allows us to keep each team member engaged and highly effective. Each team member is a subject matter expert for their own content area.