Episode Description: In this second part of her conversation with Josephine Wilton, Chief Strategy Officer at Hullanta Consulting, Rachel dives deeper into the complexities of value-based care. Josephine draws on decades of experience in managed care strategy, population health, and contract design to explore why these models often feel difficult to implement.

This episode examines the operational realities behind value-based care, including the importance of utilization data, the impact of contracts on organizational performance, and the necessity of interdisciplinary collaboration. Listeners will gain actionable insights on how to navigate these challenges, advocate for their teams, and optimize care delivery in a system that is constantly evolving.

Key Topics Discussed:

• Understanding the impact of value-based payment measures on provider organizations

• Why utilization data is critical for telling your organization's story

• Contract design and its influence on revenue, operations, and organizational outcomes

• Engaging specialists and ancillary providers in value-based care

• The role of social determinants of health in patient outcomes and reimbursement

• Strategies for data-driven decision-making and negotiating with health plans

Main Takeaways:

• Ownership of your data is essential — know your utilization metrics and communicate your story clearly

• Value-based care cannot succeed with primary care alone; specialists and ancillary providers must be included

• Contracts influence all parts of an organization, not just payment; thorough review is critical

• Collaboration across disciplines and sharing actionable data drives better outcomes

• Advocating for your organization requires persistence and strategic negotiation with health plans

Notable Quotes:

• "So it's very incumbent upon you to tell your story in your way. Don't let someone else tell your story." — Josephine Wilton

• "Primary care cannot do it alone. You need cardiology, endocrinology, podiatry, everyone involved, and they typically haven't so they're contributing to the total cost. They're seeing different needs of the patients than the other providers." — Josephine Wilton

Resources Mentioned:

• National Committee for Quality Assurance (NCQA)

• Centers for Medicare & Medicaid Services (CMS)

• National Academy for State Health Policy

• Milliman

Connect with the Guest: Josephine Wilton, MHA Chief Strategy Officer, Hullanta Consulting hullantaconsulting.com

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Music Credit: Music by Zach Harrison