In less than a decade, Morgantown, W. Va.-based WVU Medicine’s Heart and Vascular Institute has grown from 25 providers to more than 200, expanding from a $225 million regional program to a $2 billion healthcare destination, delivering nearly 450,000 patient visits in 2024.
In the past year, the Heart and Vascular Institute team performed the world’s first robotic transcatheter aortic valve replacement explant and aortic valve replacement, and the world’s first combined robotic aortic valve replacement and coronary artery bypass operation.
Vinay Badhwar, MD, executive chair of the institute, attributes the growth and success to the forward thinking mindset of three leaders — Albert Wright, WVU Medicine’s president and CEO; Clay Marsh, MD, chancellor and executive dean of West Virginia University Health Sciences; and Gordon Gee, former West Virginia University president — who supported the institute’s shift to a value-based compensation model almost 10 years ago.
Eliminating RVUs to build a culture of teamwork
“Many programs are compensated based on a salary base with an at-risk component for productivity,” Dr. Badhwar told Becker’s. “To truly enact a functional heart team model in a new environment with new procedures and changing evidence, we needed to eliminate any motivations of activity other than a commitment to evidence-based, quality-first care.”
The Heart and Vascular Institute decided to move physician contracts from RVU-based compensation to a value-based care model. WVU Medicine simultaneously supported the shift by dedicating an entire hospital floor to physician offices for the institute.
“When you think about a facility that’s at max capacity every single day, it seems counterintuitive to invest in space for administration and prioritize uniting team members for the one-heart-team concept,” Dr. Badhwar said. “But this is what we did. What physicians really want is to practice the art they trained for. Not fight for resources, but support each other.”
Nick Barcellona, senior vice president and WVU Medicine CFO, credits the institute’s expansion to Dr. Badhwar’s skill of fostering a culture of teamwork and commitment to clinical excellence.
“Yes, [this compensation] model allows us to bring in talent from across the country, but what really matters is bringing in physicians who fit this culture and make it work,” Mr. Barcellona said. “We’re recruiting people who can succeed in a collaborative model. That takes leadership. Credit goes to Dr. Badhwar and his team for consistently recruiting the right people who make a model like this function effectively.”
A value-based model rooted in public health
WVU Medicine’s systemwide mission of improving the health of West Virginians also aligns neatly with the Heart and Vascular Institute’s value-based care model.
“When you look at West Virginia from almost any health metric — heart disease, diabetes, addiction, obesity — we’re historically ranked between 40th and 50th compared to other states. If we’re going to change that, we can’t do things the way we’ve always done them,” Mr. Wright said.
“We want our physicians to be focused on improving the health and well-being of our patients, not on generating as many RVUs as possible,” Mr. Barcellona said. “It seems sort of counterintuitive to those of us who grew up in the old-school hospital-provider mentality of ‘doing more is always better.’ It’s doing less, but doing it more effectively for those who need it so you can keep patients healthy. We all win in that scenario.”
Mr. Wright said the institute’s growth and excellence are directly tied to a systemwide investment in culture.
“When you have a truly altruistic mission, your professionals can rally around that,” Mr. Wright said. “We’ve hired thousands of net new physicians in the past decade. Hiring for culture and sticking to it is hard, but when you do, you get the right people.”
For their efforts, the Heart and Vascular Institute has been able to recruit cardiologists and surgeons from institutions across the country while at the same time contributing about one-fifth of the health system’s gross revenue, Dr. Badhwar said.
“In healthcare, form follows finance. Having the right compensation models means you have to get the finances and incentives aligned in a way that will allow us to meet our mission long term,” Mr. Wright added.
Global reach anchored in mission
This financial progress has allowed the institute to expand its surgical capabilities and participate in clinical trials carried out through the National Institutes of Health, making the institute a highly sought-after healthcare destination for patients all over the world.
Dr. Badhwar, Mr. Wright and Mr. Barcellona all agreed that the institute’s commitment to a value-based care model will continue to propel the program forward while also remaining focused on WVU Medicine’s “North Star,” improving health outcomes across West Virginia.
“It’s very straightforward to care for people who fly in for high-end techniques,” Dr. Badhwar said. “But first and foremost, we are a mission- and purpose-driven organization. The original source code was by Albert Wright, Clay Marsh, and Gordon Gee. We’ve just been able to execute it.”
Leave a Reply