Three Things I Wish I Knew: Dr. Mohamed Diab

Accountable Care Organization president emphasizes long term planning, but says the work is worth the reward

Advice Mohamed Diab, MD, MBA, President, CVS Accountable Care would give to his earlier self before participating in value-based care.

Value-based care is difficult work, so it's important to have a long-term business plan that can weather the ups and down of the first few years. There will be unexpected changes, including model changes and unforeseen macro-level trends. Furthermore, care transformation takes time as we are working against the currents. However, this is the most rewarding work there is, and I am honored to be able to take part in it.

More about Dr. Diab and CVS Accountable Care’s relationship with the CMS Innovation Center:

1. What is your role in the CMS model?
   
   With the introduction of the Direct Contracting/REACH ACO Model, I saw a unique opportunity for CVS Health to extend our population health capabilities to the Medicare fee-for service (FFS) population to achieve greater health care impact, help improve the quality of care, reduce cost for the Medicare FFS population, and build a more sustainable value-based care business model for primary care providers. I led a team to build out the Accountable Care business, and we have grown organically and through an acquisition to become one of the largest groups of accountable care organizations managing Medicare FFS lives in the country. We currently manage more than 1 million Medicare FFS lives, across 40+ states, with 70K+ providers across diverse organization types such as CINs, health systems, academic health centers, small independent physicians, federal qualified health centers, rural health clinics, and critical access hospitals.
    
2. How long have you been participating in value-based care? What was your first experience?
   
   I have been involved in value-based care my entire career. I started out as a health plan executive, moved into health system consulting, and have held various leadership roles at CVS Health including building joint-ventures with health systems to manage risk and creating our Accountable Care Organizations. My experience in these various roles highlighted to me that the fragmented fee-for-service system centered on sick care does not serve the beneficiary or the provider, and that value-based care is our best option to improve the quality of care and reduce unnecessary medical cost.
    
3. What was your initial interest or reason for practicing value-based care?
   
   My father was a primary care physician (PCP), and I grew up experiencing first-hand the significant impact as well as the burden for PCPs. My father worked long hours, had a holistic understanding of all of his patients, and was a great diagnostician and healer because he could see subtle changes in his patients based on their long-standing relationships. PCPs are responsible for the patient's entire health care experience, often times, over the patient's lifetime, and yet have the lowest reimbursement among medical specialties. I believe strongly that investment in primary care is critical to ensuring both quality and sustainability for the whole health care ecosystem - patients, providers, and payors.