Creating partnerships with local Health care organizations and driving the value and benefits to home health is a top priority for industry veteran Brian Fuller, as he settles into his new role as chief strategy officer for Jackson, Michigan-based Great Lakes Caring Home Health and Hospice. His appointment was announced October 13 by the company.

Fuller has more than 15 years of experience under his belt in the post-acute care sector, featuring tenures with national, big-name health care organizations like Washington, D.C.-based Avalere Health and Brentwood, Tennessee-based naviHealth.

It wasn’t until after the implementation of the Affordable Care Act that Fuller’s background in traditional strategic roles within the industry took a shift towards value-based care, he explained to Home Health Care News.

This focus has led Fuller to specialize in and become an early adopter of bundled payments, as he’s since led provider and convener organizations participating with the Centers for Medicare and Medicaid Services (CMS), consulted with hospitals and post-acute providers on bundled payment participation, and was selected by CMS as an expert panelist in application assessment for its Bundled Payments for Care Improvement (BPCI) Initiative.

“Since then, I’ve just been staying actively involved in bundled payments and have been able to see it from other angles,” Fuller said.

This perspective is an asset he hopes to bring to his new role with Great Lakes Caring, which currently does not provide a bundled payment program. The company currently provides a range of value-based care services, including home health, hospice and palliative, care, among others, across Michigan, Illinois, Indiana, Ohio, Missouri, Kansas, Massachusetts and Maine.

Redefining care 

Throughout his career, Fuller has realized the challenges home health agencies face in creating value in the overall health care continuum, as well as delivering care that is not confined by the reimbursement system. This is where he believes bundled payment systems can play a unique role.

“I think that what bundling and [accountable care organizations] and these other structures create is really an opportunity to redefine the care delivery system and deliver care in a way that’s very different and, quite frankly, a bit more innovative than what the fee-for-service reimbursement system has incentivized,” Fuller said.

In addition to creating strategies on which markets Great Lakes Caring would like to enter, Fuller is focused on moving the organization forward on its value-based, value-centered initiatives, he explained.

“We need to do a better job going forward of driving value in very well-defined partnerships and relationships and making sure that that is connected,” he said. “I would … like to see us enter into at least one value-based care arrangement [either] on behalf of a health system or a payer that we are managing a population’s health on their behalf, and delivering the services that we need into the home.”

Disruption of technology

On a broader scale, Fuller is keeping an eye trends in the industry, among them how to create innovative partnerships across the health care spectrum.

“Whether those partnerships within home health are with other post-acute providers, or whether they go further upstream to hospitals and health systems, or all the way upstream, if you will, to the payers,” he said. “I think making sure that you’re creating the right structure and aligning incentives where opportunity exists, and doing that through partnerships is [a] key trend.”

He is also keeping a close watch on the “disruption of technology” in care delivery as a way to subsidize costs associated with talent management and turnover.

This aspect of utilizing technology can also be applied to hospice care, according to Fuller. The biggest challenge within this sector, however, is providing the offering to patients earlier in their diagnosis, he explained.

“There’s a larger, more significant group of patients who don’t elect hospice until it has minimal benefit to their lives. [There is a trend in] getting over the social and cultural barriers that create that dynamic,” he said. “I think the perceptions of the role that [hospice] plays in the end of life is a trend to watch and will hopefully continue to evolve.”

Written by Carlo Calma