Primary Care Delivers With Value-Based Care

Value base care

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Have you or a loved one has been diagnosed with a chronic disease? Was it recent? Did you suspect something unusual in your body? Or was it a coincidence that you went to your family physician for a routine check-up and learned about an undiagnosed condition?

These are not random speculations. The answers can define your health and quality of life.

Okay, there is another angle to it. As a clinician, do you/your medical staff regularly monitor your residents, especially those over 65 years old?

Again, these are not random questions. The facts can actually characterize your reputation and impact your finances as well.

Primary Care Provides Continuity of Care

For more than 30 years, the American healthcare system has emphasized the importance of Primary Care. For example, Dr. Barbara Starfield defines primary care as, “care that is characterized by first contact, accessibility, longitudinally, and comprehensiveness”

‘Continuity’ is one of the key elements of Primary Care as quality Primary Care provides

1.   Familiar Consultant [family physician]

2.   Preventive Care

3.   Health Education

4.   Early Diagnosis of Any New Disease or Condition

5.   Regular check-ups and Screening

6.   Vaccinations

More recently, the concept of providing Primary Care through a Value-Based approach advanced under the Affordable Health Care Act in 2010, commonly called Obamacare. The main aim is to shift the healthcare structure towards a Value-Based model from the traditional Fee-For-Service [FSS] approach. It is intended to work more in the context of Patient-Centered care that is proactive, thus avoiding complications and unnecessary interventions.

Value based Care:Relatively New But A ‘Win-Win’

Value-based-Care is a healthcare delivery model that prioritizes patient care outcomes over the volume of services provided. In short, it focuses on patient health and satisfaction, rather than simply increasing the number of medical procedures. Other than positive patient outcomes it is also cost-effective.

Some statistics, courtesy of Humana’s report, solidify Value-Based care.

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1. Patient growth receiving Value-Based-Care increased by 2.3 million

2. Patients under Value-Based-Care have 30.1% less rehospitalization compared to other Medicare beneficiaries

3. The program presented a 23.2% cost reduction, resulting in $527 savings per annum per patient.

Also, the American Academy of Family Physicians (AAFP) 2022 value-based care survey showed that 49% of practices are inclining towards it in some form.

And 18% are working on developing the capability to join it.

At the Fall 2023 conference of NAACOs, there were some very interesting strategies presented by known speakers from the industry, on how to engage and motivate clinicians toward Value-Based care in Primary-Care.

Catherine Smitas, Regional Medical Director of Aledade, talked about a very simple engagement process that starts with making the providers understand the concept of Value-Based Care, rather than telling them to ‘do it’, in a way that they can decide on their own that, it works in everyone’s favor. The next step would be to give them time to learn and use it in their workflow and to follow up with more data on the benefits of Value-Based Care.

Instead of starting the program from the ‘workflow’ stage, which usually is the case, doctors must understand the principles and benefits of Value-Based Care.

She also briefed about the tools for engagement, and they are

1.     Distribution Formula [Attendance at meetings, Performance metrics]

2.     Competition

3.     Continuing Medical Education

4.     Having a board definition of what is important in VBC

5.     Keeping it clinically meaningful and patient-centered

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6.     Transparency in expenditures [finances]

But Deepika Kewlani, Lead Director, Strategic Planning of CVS Accountable Care presented a different strategy that was principally addressing different practices in a customized way, and they call it ‘Wraparound Services’.

CVS focuses on 4 key areas to align and collaborate with the clinicians.:

  1. Clinical Program Models
  2. Analytics and Interoperability
  3. Accurate Clinical Documentation and Coding and
  4. Administrative Support

To successfully implement this Wraparound Services Model, CVS answers the question: “How can we align what you need to be doing for your patients across the board, across all of your value-based contracts”. In their clinical program models, they generate customized population health management solutions for each clinical model, ensuring a seamless shift to value-based care that suits each clinical practice.

Analytics and interoperability serve in classifying the clinical and social requirements of patient populations with advanced health analytics and comprehensive data. This aids by providing a suite of technology-enabled services for seamless and efficient data sharing for real-time and better patient outcomes.

Throughout the care continuum, accurate clinical documentation and coding is required for successful risk management and proactive care. And of course, appreciation and well-paid administrative staff bring the ‘happy staff, happy doctor’ equation full circle, nurturing a positive and collaborative work environment that eventually enhances patient care with Administrative Support. 

All said and done, but what can be a leverage for delivering Primary Care with Value-Based-Care?

Time to get introduced to Hucu.ai 

WHY?

Primary Care is the first point of contact between a patient and their caregiver. The element of value-based care enters into this Patient-Care provider equation when the Care Collaborators along with all the stakeholders join hands and come on one platform.

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Hucu.ai provides that much-needed most effective, HIPAA-compliant platform.

Its unique feature of “One Channel For One Specific Patient” serves the purpose of Primary Care delivering with Value-Based-Care most aptly.

Proactive And Collaborated Approach

The Value-Based approach dictates continuous monitoring of a patient. Patients with chronic disease benefit most. The care collaborator shares their observations and data on a patient in that one specific patient’s channel so everyone is updated on the patient’s acuity.

The real-time messaging and patient acuity analysis IN THE APP, provide the healthcare team the incentive to manage chronic diseases, thus, preventing further health deterioration, rehospitalization, and ER visits.

TeleMedicine

One of the key facets of the Value-Based-Primary-Care is virtual visits. The HIPAA-compliant app provides secure virtual visits to enhance patient engagement and accessibility. Not to mention, timely interventions and improved communication between the patient and the caregivers. Added bonus; patient satisfaction comes with it.

Value-Based Care is Cost-Effective Care

As the care collaborators are unanimously informed and updated, duplicate labs or tests can be avoided. Preventive and management measures also spare rehospitalization and ER visits. This cost-effective approach contributes to the overall reduction of healthcare expenditures. That can be used well in providing quality care to an increased population.

The picture says all, providing Primary Care with a Value-Based approach is certainly giving the larger population quality care without unnecessary medical services, ensuring a much better outcome for care collaborators and patients.

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