Opinion | Geisinger Health System: A Bellwether for Value-Based Care

The COVID pandemic that overwhelmed our healthcare industry and laid bare the vulnerability of our systems is relatively well contained today. Now that we’ve moved beyond crisis mode, where is U.S. healthcare headed as a system?

My hope is that we will return our attention to the health system’s transition from fee-for-service to value-based care (VBC). This entails expanding the implementation of care delivery and payment models that are aligned with “upstream” services (e.g., prevention and care coordination). The focus is on the quality of services, health promotion, access, and affordability.

I will be the first to admit that VBC is still a work in progress and even the best-intentioned models may benefit from tweaking. That said, there are a few exemplary organizations. The one I know best – a true bellwether – is Geisinger Health System (Geisinger).

Geisinger is one of the nation’s leading providers of VBC. The non-profit system serves an estimated 1.2 million people in both urban and rural communities across Pennsylvania. It encompasses 10 hospital campuses, a college of health sciences that educates more than 5,000 medical professionals, a medical school, and a broad range of residency programs that provide training for more than 500 physicians annually.

Over the past 12 months, Geisinger has enjoyed some newsworthy achievements. In April 2024, for example, Geisinger became the first leading community health system to partner with Kaiser Permanente’s (KP’s) Risant Health (Risant). Why is this important?

KP is the country’s largest non-profit healthcare system, and it has long been considered the “gold standard” for incorporating population health in an integrated care delivery and financing model. In an effort to compete with the nation’s mega for-profit giants (e.g., Aetna and Cigna), KP has launched Risant – a strategy that involves merging with and/or buying other delivery systems that share its values, operate managed care plans, and play critical roles in the communities they serve.

KP and Geisinger merged with a shared mission — to increase value in healthcare across the country — and complementary capabilities. Risant envisions improving the health of millions by increasing access to VBC and health insurance coverage. It brings to the table the necessary expertise, tools, technology, and services for success in VBC.

Geisinger uses its innovative multi-payer, multi-provider framework to drive better health across its populations, including Medicare, Medicaid, and rural segments. Importantly, KP and Geisinger share similar objectives and operating philosophies (e.g., a focus on health and wellness versus treating illnesses when they require urgent or hospital care). Both have medical schools, residency training programs, and a shared commitment to education and research.

Risant melds KP’s integrated care and coverage expertise and Geisinger’s experience with a VBC model that includes a variety of payers, a broad network of providers, and a service area with some of the region’s most vulnerable and marginalized communities. It expects to acquire 4 to 5 additional leading community-based health systems over the next 4 to 5 years.

A related achievement for Geisinger was the receipt of a 3-year, $750,000 grant from the Health Resources and Services Administration’s Rural Residency Grant Planning Program to develop a public health/general preventive medicine rural residency program. The first of its kind in Pennsylvania, the program will support the education of physicians who are: knowledgeable about the unique care needs of rural populations; trained to offer health promotions and preventive care; and well-prepared to practice in rural and underserved communities. Masters-level education in population health will be embedded in the program. Michelle Thompson, MD, Vice Dean for Graduate Medical Education and Chief Education Officer, anticipates initial residency accreditation for the 3-year program in 2026, with the first class of two residents matriculating in 2027.

Looking at Geisinger in its new relationship with Risant gives me real hope for the future of U.S. healthcare – hope for making more effective use of our resources while improving the health of all Americans and their unique communities. Yes, we can!

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