In this episode, CHESS Vice President of Value-based Operations, Josh Vire, talks with Wilson Gabbard, Vice President of Quality and Condition Management at Advocate Health, about how to gather and present meaningful data to providers in an easy and accessible way which enhances their delivery of better patient care.

Well, Wilson Gabbard, thank you for joining us on the Move to Value podcast.

Thanks, Josh. Thanks for having me. It's good to be here.

Great. Wilson, I know you have a wealth of knowledge, both population health and value based care. Can you just start by giving our audits an overview, a little bit about you, your background, where you've been, what you've been, what you're up to today, and your responsibilities at Advocate Health?

Yeah, absolutely. Well, again, Josh, good to be here. You know, value our friends and colleagues at CHESS and have long followed all the great work that you all have done. And so, it's a privilege to be here. Again, you know, by way of background, I'm a former practice operator, used to lead clinic operations in Eastern North Carolina and had the privilege of kind of pivoting into a population health focused role back in 2013. So, over a decade ago now helping build out some of this work in a prior life. And you know, over the years it's been really interesting to see the evolution of value and how we've gone to taking on more risk and building out more sophisticated programs and blending together Medicare Advantage and MSSP or different value-based programs together to ultimately really just better serve the patients and clinicians that were really just privileged to be able to serve on a daily basis. So, you know, today what I'm up to is here at Advocate Health, I have the pleasure of leading quality and condition management efforts as part of our enterprise population health structure. You know, we think about value-based work and kind of the formulaic equation that is driven based on three main components, which are quality, utilization and premium and lives. And how we do that, how we operationalize that is really around the two functions that I again have the privilege of kind of serving in or related to the quality and condition management work and have the again opportunity to do that along a really amazing physician dyad, who I feel very privileged to work alongside as we implement some of these programs.

That's great, Wilson, thanks for that background and I'm glad to share that with the audience. You mentioned you've been you've been at this for a while, you're very well versed on what drives and improves contracts in value-based care. So really excited about again having you here and could you go a little bit layer deeper in what is condition management and documentation? What does that mean specifically at Advocate and a little bit about what your how your role plays in supporting value-based care efforts.

Yeah, great question. I think that our approach to value and again I think value-based care is you know the corollary or antithesis maybe is the wrong word, but to fee for service, right. As we move from fee for service to value, we think about the premium and lives component that I mentioned earlier about ensuring that we are receiving the appropriate reimbursement for the patients that we're caring for. And the way that CMS, our government programs have implemented that financial model and value is through a risk adjusted payment mechanism. But at the end of the day, the way that we think about risk adjustment here at Advocate is that risk adjustment really at its core is just a population health fundamental that ensures that it's really, it's all about ensuring that patients and their conditions are not lost to care. In value-based care, I love that the focus is not about on widget counting, but rather on caring for conditions, ensuring that those...