Health Uncapped

Eric Pfleger (Chief Population Health Officer @ Southeast Primary Care Partners) had a theory he wanted to prove before one of his physician dinners. So he pulled the numbers. Patients who got about 40% of their care from the primary care practice had half the ER visits, half the inpatient stays and roughly half the spend.

On this episode of Health Uncapped, Eric talks about why that matters more now that risk coding alone won't make value-based care work.

We cover:

- The 40% cutoff for keeping patients anchored in primary care

- What V28 and CMS audits mean for risk coding

- Why dementia goes underdiagnosed and uncoded in primary care

- Paying for care teams before value-based dollars show up

- What the ACO LEAD model changes for high-needs patients

- Standardizing care without taking away physician autonomy