Value Based Health Care – Ready or Not

healthcare collaborationNo one working in healthcare can deny the shift that’s occurring from volume-based to value-based patient care and reimbursement.  The pace varies depending on your market demographics, but the change itself is undeniable.

The shift toward value-based healthcare impacts every payor category – federal and state based programs as well as commercial payers are placing increasing reimbursement value on the quality of care provided versus the volume and type of services performed.  This shift can impact providers significantly as they work to redesign models that have historically depended on fee-for-service patient volumes.

  • How ARE other providers responding to this shift, recognizing that there will be short term financial pain?
  • How can you best prepare for value-based care for your organization?

Thoughtful Strategic Approach

Industry leaders who are shifting toward value based care have made a conscious decision that improving value was more important to them than shorter term fee-for-service profits.  They were intentional in their investments of business plans based on value.  Leadership demonstrated firm support of putting the patient first.  Most of the early innovators share similar advantages around financial stability, positive physician relationships and strong information technology infrastructure.

Another deliberate approach these organizations employ is the application of care redesign to all patients – not just those in payer contracts that would create financial benefit for the organization.  Leadership again stands firm with the message that value-based care must create value for all patients, not just a select group o

Benefits aren’t just for Patients

Providers are using a variety of process improvement efforts to improve patient care quality.   Results include improved patient outcomes, higher satisfaction of patient care experience, reduction in time wasted, and lowered health risks/readmissions.

As these results, have been realized, organizations are experiencing substantial employee morale improvement, greater teamwork, and even lowered employee turnover rates.

Another positive by-product of pursuing value-based care is the virtually mandatory requirement of relationship building – a provider can’t drive value alone and must work together with others, including physicians, community agencies and other provider organizations.  It truly takes collaboration from the group to ensure patient care needs are met in the most cost-effective, high-quality manner.  This alone is a monumental shift for some providers who have operated within competitive environments for many years.

Not a Matter of If, but When

Healthcare has begun a gradual, but certain, replacement of fee-for-service business models, and providers who do not begin adapting to the trend will be left behind.

Providers who continue to care for patients under an outdated fee-for-service model will likely encounter higher financial costs as payers begin shifting their business to competitors who have developed and provided higher-value care.

As patient consumerism continues to build around cost-effective, highest quality care, society will expect a provider who can meet and exceed those expectations.

Are you ready?  Contact Soriant Solutions today!