Physicians: 4 Steps to Move Toward a Value Based Care Model

You want to transition from fee-for-service to a value based care model, but you don’t know where to start. Indeed, there are challenges! For example, you’ll need a robust infrastructure to collect and analyze data on patient outcomes and costs. 

You’ll also want to align provider incentives to focus on quality rather than quantity of care. Staff may lack adequate training in care coordination with external organizations. And your existing IT systems may not support the level of data integration you need to succeed.

Focus on the Benefits

If done properly, there will be a financial upside for your practice once you make the move. You may receive a bonus, for example, if a certain percentage of your patients have mammograms within a certain timeframe, or if you prescribe a certain percentage of generic vs. brand drugs. By ensuring that your patients receive timely preventive care, you could help them avoid costly emergency room visits. Everyone wins while costs go down.

Begin By Taking These 4 Steps

To transition successfully to a value based care model, practices need to:

  1. Invest in advanced data analytics tools to track patient outcomes and costs so you can address areas for improvement.
  2. It’s essential to develop care coordination plans to manage patients with chronic conditions more effectively.
  3. Align provider incentives with quality metrics — this will ensure everyone is working toward the same goals.
  4. It’s imperative to establish partnerships with other healthcare providers and community resources to offer comprehensive care. Then you’ll need to train staff in new workflows and care coordination techniques.

Act Now

Without a shift to value based care, practices risk falling behind in an increasingly competitive healthcare market. Pay-for-performance (P4P) models are becoming more prevalent, and failure to adapt can lead to reduced reimbursements and financial instability. Moreover, the inability to demonstrate high quality care can result in poor patient outcomes and lower patient satisfaction, which further impacts a practice’s reputation and profitability.

We Can Help

HealthNET Systems Consulting can facilitate your transition to value based care in several ways. First, we are experts in advanced data analytics that monitor patient outcomes and costs, so we can help your practice come up to speed if that’s a problem area for you.

Additionally, we can help develop and implement care coordination plans tailored to your practice’s patient population, align incentives with quality metrics, and provide ongoing training and support for staff. We can also give you guidance in establishing partnerships with local hospitals, specialists, and/or community resources to enhance patient outcomes and ensure financial stability through higher reimbursements and improved patient satisfaction.

Contact us today to learn more.

Blog Post Author:

Mary Ann Keane, President

Mary Ann Keane, MS, RN President

Mary Ann Keane brings decades of IT, healthcare operations, and nursing administrative experience to HealthNET. She was Director of Nursing at a major medical center, where she was responsible for Nursing Informatics, Medical/Surgical, and Maternal Child Health Nursing. Her background is augmented by notable accomplishments in IT strategic planning, IT assessments, system selections, EHR implementations and Promoting Interoperability planning and project management. Mary Ann is an outstanding facilitator, presenter, and thought leader. She earned her BS in Nursing from the University of Massachusetts in Boston and her MS in Management from Lesley University. 

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