Lili Brillstein is a nationally recognized thought leader in the advancement of Episodes of Care as a value-based approach for specialty care. She is the Director of Episodes of Care for the Market Innovations team of Horizon Blue Cross Blue Shield of New Jersey, and, under her leadership, has built the largest program for commercially insured patients in the country.
Lili is responsible for the overall direction, strategy, design and oversight of the Horizon Episodes of Care/Bundled Payment Program. When Lili joined Horizon in January of 2013, the Episodes program was still in pilot and included only total hip and total knee replacement episodes. The program has grown to include additional orthopaedic episodes (including low back/laminectomy, shoulder replacement, knee arthroscopy), obstetrics and gynecology, GI (including a Crohn’s episode with a fully integrated behavioral health component), cardiology, and oncology.
Lili is a passionate advocate of Episodes of Care/Bundled Payments as a strategy to successfully migrate from fee for service to quality- & value-based models that rewards providers for excellent outcomes and patient experience, while reducing the overall cost of healthcare.
Lili is a guest lecturer on episodes of care/bundled payments at the Harvard Business School working under Michael Porter, 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.
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 has shifted from one of adversaries to one of collaborators.