Value-based care has been an emerging healthcare trend for the past decade. The Centers for Medicare & Medicaid Services (CMS) launched value-based payment models in 2016. As part of the agency’s Meaningful Measures Initiative, a set of programs designed to improve patient outcomes and lower costs by rewarding healthcare providers who demonstrate effective treatment methods. Instead of the traditional fee-for-service model, which reimburses healthcare providers depending on how many services they perform rather than on whether those services positively affect patients. These value-based care rewards practices provide more affordable and effective care.
It was understood that the majority of Medicare expenses occur from the first 90 days of admission. A decade ago, Bundled Payments for Care Improvement (BPCI) sharpened the focus and developed a model that rewards doing what is suitable for patients. Implementing the value-based approach resulted in an increase of 26% in readmissions within 30 days, a 60% decrease in Long-term acute care hospitals (LTACHs) usage, and a 31% decrease in SNF utilization to the BPCI patients.
It is also discovered that a universal approach to the partnership could be more effective in terms of value. Each market is different, and each partner’s needs are different, so forming flexible partnerships which can be customized to meet the specific needs of a community is crucial. To scale programs effectively and efficiently, we need to utilize the power of telemedicine and other technologies to connect patients to hospitalists outside of the hospital’s four walls.
Value-based care also allows providers to receive reimbursement based on their ability to meet measurable objectives, such as lowering costs or improving a patient’s quality of life in addition to simply meeting a quota of services performed. The following are five essential tips for effectively implementing value-based care:
- Define and Measure your Outcomes.
The First Step To Effective Value-Based Care Is Clearly defining your treatment outcomes. Outcomes are the specific goals you are trying to achieve with treatment and the expected outcomes of each patient based on their situation and needs. There are several outcomes that value-based care providers are required to meet, including but not limited to the following:
- Reducing hospital readmissions – once a patient has been discharged from the hospital, reducing their risk of being readmitted to the hospital.
- Reducing patient mortality – reducing the probability that a patient will die within a given period of time.
- Reducing emergency room visits – reducing the number of times patients visit the ER for non-emergency services.
- Increasing patient satisfaction – improving the overall quality of care patients receive.
- Increasing patient adherence to medical regimens – reducing the number of patients who stop taking their prescribed medication once they’ve been discharged.
- Reducing healthcare costs – reducing the overall cost per patient visit.
- Make the Most of your Data.
The most effective value-based care providers make the most of their data. Data provides insight into the effectiveness of current treatment methods and helps providers identify areas for improvement. The most critical data for value-based care providers to collect is patient-specific data that can be used to determine each patient’s individual needs and expected outcomes. This kind of data can help providers identify which patients are most likely to experience positive outcomes and determine what types of treatment are most effective for each patient.
With Hucu.ai, you can securely connect with network partners, patients, and family members of patients in one universal system and use HIPAA-compliant instant messages for your facility’s internal communications. It is also able to incorporate into your EHR to increase the efficiency of your staff. Hucu.ai’s data analytics monitor patients’ understanding, user engagement reports, and visibility into partner performance; in addition, Users can keep track of live data! Self-service signup enables new users to start using the application in a matter of minutes instead of enduring months or even years of configuration before using the app and being available. It has built-in features that make communicating between employees and collaborators working across different institutions while taking care of the same patients easier.
- Use Care Coordination to Improve Outcomes.
One of the most important factors in value-based care is care coordination. Care coordination is the coordination of all aspects of a patient’s care, including scheduling, diagnostic testing, and prescription monitoring. Care coordination helps providers map out a course of treatment that is most effective for each patient. Care coordination allows providers to maximize the benefits of value-based care by ensuring that patients receive the treatment they need at the right time, in the right amount, and with the right amount of supervision.
- Offer Flexible Services
Value-based care providers must offer flexible services that can be tailored to each patient’s needs and expectations. Flexible services allow providers to offer a range of treatment options so patients can choose the best care level. Value-based care providers are also required to offer patients different payment options so that patients who may not have the necessary financial resources to cover the cost of care can still receive treatment.
- Be Transparent with Patients.
Finally, value-based care providers must be transparent about the costs and benefits of treatment options. Value-based care is designed to create a win-win situation for patients, providers, and insurance companies — but only if patients are fully aware of the potential benefits of value-based care and are given the opportunity to participate. Value-based care works best when providers take the time to fully explain the process to patients, complete with expected outcomes, treatment methods, and payment options. Patients who are fully aware of the benefits of value-based care are more likely to participate, which can help providers meet the requirements of value-based care and receive appropriate reimbursement for effective treatment.
Conclusion
Value-based care is the new paradigm for reimbursement in the healthcare industry. In value-based care, hospitals and other providers are rewarded for improving the health outcomes of their patients instead of simply the number of services they provide. The ultimate goal of value-based care is to reward providers who improve patient health while reducing unnecessary costs. To succeed in this new model, healthcare organizations must implement strategies that drive value based on evidence from clinical data and patient experience.
Value-based reimbursement models are the future of healthcare financing. Value-based models pay for care that is proven to be effective rather than just paying for particular procedures or hospital stays. Value-based reimbursement incentivizes healthcare organizations to improve outcomes and patient experience while lowering costs. To succeed, hospitals need to understand how the new value-based reimbursement models work, build a strong case for value-based treatment, and implement an actionable plan.
