Value-Based Care Solutions for Healthcare Providers
Value-Based Care Solutions for Healthcare Providers
Now more than ever, the industry is demanding better quality and more cost-effective care.
Value-based care (VBC) solutions can help healthcare provider organizations feel more prepared to effectively adjust to VBC reimbursement models, while they take steps to protect and grow their margins, develop strategies to maximize their people and technology investments and improve health outcomes for their patients.
Advantages of adopting value-based care programs
Improve physician engagement
VBC programs offer significant benefits for providers by enhancing physician engagement, which in turn leads to better patient outcomes and improved operational efficiency. These programs go beyond traditional compensation models, fostering a stronger alignment between physician behavior and VBC goals. By incentivizing a focus on overall patient health, VBC programs encourage providers to prioritize preventative care, chronic disease management, and integrated care plans, driving higher-quality care delivery and improved care coordination.
Enhance payer relations
VBC models require close collaboration between healthcare providers and their payers. Achieving success requires aligning incentives, setting shared objectives, improving data integration and ensuring visibility into performance, all of which contribute to enhanced payer relations.
Increase patient engagement
Leveraging new technologies and enhancing data analytics are essential for improving patient interactions and health outcomes. An effective and well-implemented EHR serves as a crucial tool for creating personalized, data-driven patient engagement strategies, ultimately driving both better health outcomes and enhanced revenue.
Advance network organization
To thrive in a VBC environment, providers must expand and integrate their networks, enhance data sharing, and build new capabilities for managing risk and collaboration across the care continuum. Leveraging EHR systems can improve data management, help identify high-performers or areas needing improvement and ensure providers have the right information when caring for patients, ultimately facilitating better care coordination and improving patient outcomes.
Promote information sharing
Data sharing, both internally and across your network, is essential to the success of your VBC program. Effective use of your EHR platform features can enable better data integration and timely data exchanges between providers and payers, streamline information sharing, the ability to manage risks and provide a more coordinated approach to care delivery. To overcome these challenges, providers must improve data integration, ensure actionable insights, and establish flexible, future-proof systems for seamless information flow across the care continuum.
Increase cost efficiency and financial rewards
Value-based reimbursement models financially incentivize providers who meet program goals, offering additional revenue opportunities to strengthen their financial health. By promoting coordinated care, many VBC programs can minimize redundant services, streamline processes and improve patient steerage, leading to more efficient use of healthcare resources and fewer costly emergency interventions or hospital readmissions.
Market trends: The journey to value-based care
Every year, the Health Care Payment Learning & Action Network (HCPLAN) undertakes a national initiative to evaluate the adoption of alternative payment models (APMs) over time and monitor progress toward its objectives. Since its inception in 2015, the Measurement Effort has expanded to include data from a substantial sample of health plans, covering nearly 80% of Americans. This initiative now provides the most comprehensive snapshot available for assessing advancements in payment reform.
While 59% of spending is still going to fee for service models, 41% of spending have transitioned to sophisticated VBC arrangements, which is expected to continually increase
Medicare advantage is leading the way by spending 57% of dollars in APMs by VBC arrangements, followed by Medicare (42%), Medicaid (40%) and commercial (35%).
