The shift from fee-for-service to value-based care is well underway, and like it or not, gaining momentum.  This shift is accompanied by many questions, a sense of uncertainty and an appetite for guidance. 

With this in mind, our team at Focus Solutions is sharing a three-part series of short articles dedicated to value-based care.   

This is the first installment with a focus on the core components of value-based care.

The first step to understanding value-based care is understanding the definition of value. In healthcare, the equation for value is often defined as health outcome divided by cost.

Although the equation seems logical, the current system doesn’t always properly support this equation. Patients and physicians are often encouraged to pursue services without a solid regard for maximized health outcomes. Fee-for-service payment models have traditionally incented demand for more services with less focus on important factors like prevention and coordination of care.

Further, healthcare technological advancements, while great, can bombard patients and physicians with too many options in terms of care delivery.  This means more drugs, tests and procedures – sometimes necessary, other times not so much.

Additionally, physicians are often isolated from the big-picture view of a patient’s overall care and left struggling with a vast administrative workload. This includes grasping to understand different quality metrics, varying pay-for-performance programs, and unique payer rules.

And let’s not forget about the patient who is left navigating a complex and confusing healthcare environment with little help.

Safe to say, this traditional model is not sustainable for the patient or the practice.

These issues are driving this healthcare industry shift towards value-based care.

What can your practice do to adapt to value-based care model?

 

Focus on the customer  

We know it sound like a no-brainer, but we all must remember the simple fact that everything revolves around the patient. Amid the complex healthcare environment, it’s essential to never lose sight of the patient and their perspective. Focus on elements like access, convenience and experience. This includes developing custom fit patient-centric programs.  Such programs identify behavioral changes to proactively manage diseases and potential lifestyle risks – such as exercise, weight loss and healthy food choices. Through this, your practice also better equips patients to engage in their own care.

 

Be intentional in coordinating care

Together with the patient, put your practice at the center of coordinating their care – across the many different sites of care, various providers, and array of services.

For example, a patient with many chronic illnesses may be on various medications, bouncing between inpatient and outpatient facilities, and switching back and forth from primary to specialty care. Without intentional help in coordinating their care, such a patient is often left feeling overwhelmed and uncertain. Your practice and physicians should be their advocate – helping patients navigate through the healthcare system while making it known they’re not alone in the process.

 

Prioritize value over volume

There are a variety of ways physicians can participate in value-based reimbursement. With an extensive list of options, rest assured you have ways to maximize your revenue without being solely obsessive with patient throughput.  This is the beauty of the value-based model.  It allows your practice to spend time and resources on helping the patient maximize their experience and health outcomes, without sacrificing your financial stability.

Our Focus Solutions team is well-versed at guiding healthcare practices in bringing these core components to fruition. We are experts at navigating the questions and uncertainty of transitioning from a fee-for-service model to a value-based model – this includes balancing the patient experience with the sustainability of your practice’s financial picture.

Want to learn more?

Join us for part two of this series where we focus on the benefits of value-based care.

In the meantime, our Focus Solutions team is always here to help.