Intro To Value-Based Care: Quality Over Quantity

What is Value-Based Care anyway?

Simply put, it’s healthcare that incentivizes quality of care over quantity of care. This relies on knowing more about your patients, identifying potential conditions earlier, and treating them sooner.

The “value” concept is a comparison of patients’ outcomes to how much it costs to deliver those outcomes. The ultimate goal is to improve our patients’ outcomes while decreasing overall costs.

Who’s impacted by this new approach?

Many processes are repetitive in nature, but are essential and need to be completed accurately and timely. We templatize, automate, and measure these activities so that everything is tracked and monitored.

Patients Improve health while spending less. The focus is on helping patients to prevent diseases, manage existing conditions, and minimize recovery times. Accomplishing these goals will result in fewer doctor visits, hospital admissions, procedures, and needed medications.

Providers Improve patient satisfaction and efficiency. The shift from reactive to preventive care provides a shift from chronic desease management to early diagnoses and patient education. This results in improved patient engagement rather than patient volume.

Payors Decrease costs while reducing risk. Risk is reduced with improved diagnoses and a larger patient population in Value Based Care relationships. Preventive care also leads to less medical claims which results in lower premiums and expenses.

It’s really here to stay. CMS commited to transitioning all beneficiaries into Value Based Care by 2030.

So, what does this mean for me?

Value-Based Care will impact you now or in the near future. For hundreds of our provider partners, transitioning to Value Based Care has had a positive impact on their and their patients' lives.

They were able to get back to focusing on providing the care they felt patients deserved. Their practice returned to being about establishing a trusted relationship, rather than a transactional experience.

There are many ways you can implement Value-Based Care, but there are a few commonalities that you will experience.

Emphasis on preventive care. More data about each patient empowering you with a more holistic picture of their overall health.

Earn additional compensation. You will be compensated for improving the outcomes of your patients'.

Prioritize your patient panel. Some patients require more facetime than others, or need urgent followups after hospital discharges.

How will I get paid differently?

Value-Based Care will impact you now or in the near future. For hundreds of our provider partners, transitioning to Value Based Care has had a positive impact on their and their patients' lives.

Fee for service and shared savings earnings. This hybrid approach enables you to bill as you currently do, but have the ability to participate in the savings your efforts generate from improved patient outcomes.

Guaranteed payment and shared savings earnings. This pure approach affords you a guaranteed base payment, often greater than your normal fee for service billings, and the ability to also participate in the savings you generate.

Can I even implement Value Based Care?

Yes, you can and you have options. Most choose to partner with a specialist like us with the tools and resources needed, but you can also do it yourself. Ultimately, you must answer five main questions:

Is your practice ready to deliver Value Based Care? With the focus being on prevention, there many items needed to be in place to succeed. These can be grouped into Technology, Staffing, and Processes.

What's your level of risk tolerance? There are different ways you can participate in a Value Based Care arrangement depending on how much risk you'd like to take. Contracts range from no-risk to full-risk.

Do you understand the requirements and process? Patient outcomes are critical to determining your success. There are numerous practices that need to be implemented, monitored, and reported.

What is the composition of your patient panel? Each payor type has unique approaches to Value Based Care, and these can determine how you support and provide care to your whole panel.

How willing are you to learn new approaches? The requirements to deliver Value Based Care have components that are distinct from a fee-for-service model. Some are more similar while others are completely new concepts.

Transforming from reactive to proactive care, together.

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