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On this week’s Vital Signs, Nikhil Krishnan and I sat down with Bryony Winn, President at Carelon Health. Carelon Health is the diversified services business within Elevance Health, serving 1 in 3 Americans through advanced primary care, behavioral health, specialty enablement, and whole health solutions. We discuss what's top of mind for payers today, making value-based care work, creating effective provider partnerships, and more. Some highlights: ⚡ What startups stand out to her Bryony outlines 4 things that she pays attention to with startups: 1) Founders with clinical/scientific expertise who are using that to drive results. 2) Solutions that can practically plug in to existing operations. 3) Founders who are honest about their competitors. 4) Founders who show humility and understand there’s a lot to learn from the payers they partner with. ⚡ Succeeding in Value Based Care Bryony is a firm believer that downside risk is crucial to VBC. Elevance’s approach to VBC has 3 components: contract, collaborate, and connect. Beyond the details around attribution and benchmarks, they think a lot about better sharing of lessons learned on best practices as well as connecting the dots on trends that are out of providers’ control. Lastly, Bryony emphasizes that focus yields results – players for whom VBC is only a small part of their business won’t appropriately focus on it. ⚡ What’s happening with commercial payers Bryony makes 5 key points: 1) It’s a shame that employers have had to become experts on healthcare. 2) The day of point solutions is now over, and integration is the new name of the game. 3) Employers are excited about value-based care, but they don’t want to be responsible for the specific details of it. 4) Employers work to support their employee base, so many of their worries are fundamentally human worries, such as mental health, caring for aging parents, and caring for young children. 5) While much innovation has been driven by commercial in the past, there’s currently a pivot where more innovation is starting in Medicaid and expanding from there. ⚡ Payor focus areas and provider collaboration Bryony explains how payers want to be both better business and clinical partners to providers. She highlights how bi-directional data sharing with providers results in greater alignment in care decisions and thus fewer denials and overturns. On the clinical side, payers have a more longitudinal and broader view of patients’ social needs as a result of their large datasets, which should complement the proximal view of patients that individual clinicians have. Lots of great learnings from the payer perspective in this one! Listen to our full episode below: Spotify: https://spoti.fi/4gT4oN7 Apple: https://apple.co/3YgcpnV