Janet Hughes, MBA

Janet Hughes is a Senior Director of product marketing with Valence Health. Throughout her 25 year healthcare career, she has been able to combine consulting and industry roles to facilitate the critical interactions among healthcare providers, payers and suppliers. Prior to joining Valence Health, Janet was a Principal with IMS Health, where she helped leading global pharmaceutical organizations improve their therapeutically aligned sales and marketing offerings, managed market strategies and health informatics efforts. Janet has also worked for public and private sector providers and health insurance organizations, including several state Medicaid agencies. Her experience has specifically let her improve standards of care, develop managed care products, introduce quality of care programs and reduce costs for a wide variety of health care providers. Janet has also helped numerous organizations design and implement population health programs and interventions.

j hughesThe value-based care transformation has been front and center in the news recently. Specifically, the Centers for Medicare & Medicaid Services (CMS) announced its goal to shift 90 percent of Medicare healthcare payments toward value-based models by 2018. Additionally, a new Health Care Transformation Task Force issued an ambitious challenge to healthcare systems and private insurance companies to ensure that three-quarters of their healthcare business is managed through value-based care arrangements by 2020.

What does this mean? Fee-for-service reimbursements and the care models that a fee-for-service structure often incentivize are no longer long-term options for providers. Yet every hospital and health system has its own unique characteristics, so no one value-based care model will work across all healthcare organizations. Because of this, it is critical for organizations to evaluate their strengths and weaknesses across a variety of areas that impact which models will make the most sense – in essence, providers must be aware of their own readiness to crawl, walk, or run into accepting clinical and financial risk for patient populations.