Payer Voice

Lili Brillstein, MPH, is a nationally recognized thought leader in the collaborative advancement of Episodes of Care as a value-based approach for specialty care. She is the Founder and CEO of BCollaborative, which works with stakeholders across the healthcare continuum to successfully make the move from fee for service to value based healthcare.

She was formerly the Director of Specialty Care Value Based Models for Horizon Blue Cross Blue Shield of New Jersey, and, under her leadership, built the largest, most progressive and most collaborative Episodes of Care program for commercially insured patients in the country.

Lili is a passionate advocate of Episodes of Care/Bundled Payments as a strategy to successfully migrate from fee for service to quality- and value-based models that rewards providers for excellent outcomes and patient experience, while reducing the overall cost of healthcare. One of the hallmarks of her perspective is the criticality of beginning with models that do not include a risk transfer to providers until all of the stakeholders have worked together in a retrospective, no risk model and achieved success. The goal is to cultivate functional partnerships aligned around the patient and improve their experiences and outcomes, and ultimately reduce unnecessary care and waste.

Lili is a guest lecturer on episodes of care/bundled payments at the Harvard Business School working with Michael Porter and team, and has co-authored several peer-reviewed articles on the subject of Episodes. In addition, Lili has served as an Advisor to CMS on bundled payments, and is on the Advisory Boards of the US Women’s Health Alliance and the Quality Cancer Care Alliance; both national coalitions focused on advancing value based care to improve quality and cost of care delivery. She is also an Adjunct Associate Professor at The Rutgers School of Pharmacy, and a member of the Board of Directors for the NJ Coalition to End Domestic Violence.

Lili’s expertise at cultivating functionally collaborative relationships between payers and providers across the full continuum of health care has allowed not only the pillars of the triple aim to be achieved, but the spirit of the relationships between the parties to shift from one of adversaries to one of collaborators.

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