Posted by: Ashley Choate
Before value-based care, most providers operated on a simple fee-for-service system that seemed to operate best when there were lots of fees and services to add up. Basically, the system rewarded practices and hospitals that operated less efficiently, and theoretically, may have enabled high hospital readmission numbers.
To remedy these issues, value-based care was introduced, along with several other initiatives to overhaul the healthcare system in the U.S. Many of these efforts were backed by federal laws such as the HITECH Act and the Affordable Care Act. While these laws are still surrounded by controversy, the fact is that they pushed for major changes within the industry—sparking an evolution in how providers approach patient treatment.
Value-based care is largely supported by the Centers for Medicaid and Medicare Services (CMS), whose primary goals are improving care not just for individuals, but for the wider population and communities. The initiative is also intended to help lower costs, since the national average for yearly healthcare expenditures in the U.S. (per capita) is excessively higher than any other industrialized nation. The CMS is pushing this change through financial incentives paid to practices and hospitals for achieving measurable improvements in overall quality of care for individuals with Medicare.
Specific value-based care programs include:
- Hospital Value-Based Purchasing (HVBP) Program
- Hospital Readmission Reduction (HRR) Programs
- Value Modifier (VM) Program
- Hospital Acquired Conditions (HAC) Program
- End-Stage Renal Disease (ESRD) Quality Initiative Program
- Skilled Nursing Facility Value-Based Program (SNFVBP)
- Home Health Value-Based Program (HHVBP)
Each program has specific rules and requirements to qualify for incentives, but with programs like these, finding the motivation to change is easy. Still, some practices have struggled with turning the theory of improved quality care into reality.
Below are some tips to help make the right changes in your practice in order to qualify for value-based care programs and incentives.
Focus on the patient
Ensure all changes within the practice center around improving patient interaction, patient engagement, patient comfort, and general health outcomes for the patient. This includes focusing on proactive, preventive care instead of post-incident treatment for injury or illness.
Set measurable goals
Value-based care programs require documentation and measurable progress. Various new health technology options allow practices to track data, health records, and patient progress in ways that can be used to make a case for improved quality of care. Measurable aspects should include employee engagement, particularly any employees who interacts directly with patients. Positive employee outcomes and attitudes channel into positive patient interactions.
Explore, experiment, and research the competition
Practices that embrace value-based care will ultimately have an advantage over the competition. They will embrace experimentation, new technological advantages to save money and increase efficiency, and a willingness to learn from others who are doing it right. In the end, the entrepreneurial approach to improving the way they care for patients will both attract new patients and retain the old ones.
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Change is never easy, but some changes are worth the investment. By adopting a value-based care approach, your practice can enjoy the short-term financial benefits offered by the CMS as well as the long-term satisfaction of watching your practice and patients thrive. After all, value-based care is built around the patients—and happy, healthy patients continue returning to their providers again and again throughout their very long, healthy lives.