Steps to Take for a Smooth Transition to Value-Based Care

Home > Electronic Health Record > Steps to Take for a Smooth Transition to Value-Based Care

TL;DR
Health Information Technology or HIT is becoming a more apparent need to many healthcare practitioners. This article points out great suggested steps sourced from the Harvard Business Review.

Value-based Care

The current buzz in the healthcare industry has been all about transitioning from a fee-for-service model and instituting a value-based model of care. In a fee-for-service model, providers charge by the services performed; value-based care places more emphasis on improving patient care and outcomes while maintaining low costs. Essentially, it’s restructuring the core of today’s healthcare model. However, this means several administrative changes, specifically in billing.

Many practices have just finally adjusted to the difficult transition from paper records to electronic records and now, implementing further changes seems like an unnecessary hassle. They may be tempted to put it off, but the best course of action is to complete it immediately.

Wellcentive Inc.’s Mason Beard says postponing this action is a “missed opportunity.” This is actually a situation physicians should be taking advantage of. The value-based model is built around the needs of the patient rather than the acts of the physician. This shift is necessary for many reasons. Employers are seeking to reduce healthcare expenses and patients are seeing more and more high-deductible health plans, which forces them to pay higher out-of-pocket prices. Though physicians are eager to care for their patients, in order to keep their businesses afloat, the transition to value-based care isn’t just advised – it’s crucial.

As Dr. Beard suggests, this is an opportunity to take advantage of. This is a chance for physicians to take matters into their own hands and renovate healthcare. An article in the Harvard Business Review suggests a few pointers:

  • Consolidate into Integrated Practice Units – IPUs are structured based on a specific medial condition. The team will include all clinical and administrative employees needed to treat the condition.
  • Measure Value – keeping track of patient outcomes and the steps taken toward achieving that outcome will help to pinpoint effective and ineffective practices. The outcomes should be considered by the condition instead of the specialty for full value of the data.
  • Bundle Payments – this payment model depends on overall care for a patient rather than just billing for the number of services provided. The model should include severity adjustments or eligibility only for qualifying patients; care guarantees for liability; stop-loss provisions; and mandatory outcomes reporting.
  • Integrate Care Delivery Systems – the services a provider cannot effectively provide should be eliminated and focus should be on concentrating care to fewer locations. Some conditions are better treated in lower-cost facilities and should be done so. However, the most important thing is to coordinate care across multiple facilities.
  • Expand Geographic Reach – medical centers can have satellite locations for easier access to long-term care or an IPU can become affiliated with local organizations to reach a wider range of patients.
  • Enabling Information Technology Platform – the IT system will assist in management and ensuring each aspect is in sync.

In the end, health IT is what keeps track of the details and coordinates each of these points to function systematically, while also collecting valuable data on quality and efficiency. Without a proper health IT solution, the transition to value-based care cannot effectively occur. Delaying this task will only curb impending progress.

Author: Apoorva Anupindi

Leave a Reply