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 third article of the series with an emphasis on how to transition your practice to a value-based model.

A paradigm change is underway in the healthcare industry. The fee-for-service mindset is quickly being replaced with value-based care.

This transition can require a substantial amount of adjustment to your practice. However, with the big picture in mind, this move is incredibly important to the overall health of the U.S. population and the prospect of controlling unsustainable healthcare costs.


There are a multitude of reasons for the necessity of this healthcare industry paradigm shift. For instance, Americans seem to be getting sicker, and are not managing their health effectively. The Centers for Disease Control and Prevention (CDC) reports six in ten Americans are living with a chronic disease and are often untreated.

What’s more, the CDC findings show:

• 70 percent of people with high cholesterol don’t have it under control
• 46 percent of people with hypertension don’t have their blood pressure managed
• 43 percent of people with diagnosed diabetes have poorly controlled blood sugar levels

Something needs to change. The value-based care model uses a proactive approach and an aligned payment structure to ensure both patients and providers are successful in collaboratively managing health.

With this in mind, here are some tips to consider as you plan your transition to a value-based model:

Know your resources and share the workload
The first steps towards successfully adopting value-based care are to realize the work should be distributed, and then understand that resources are available to support your practice. For example, Humana provides a vast amount of support for you and your practice – including colleague physicians in your area to answer questions, and representatives to help with administrative needs. A successful switch to value-based care does not fall on any one person’s shoulders, it’s an all hands on deck ordeal. And this includes leveraging health plan and insurance carrier resources.

Commit to a culture of quality improvement
In the long-run, value-based care will not only benefit the health of your patients, it will also improve the well-being of providers and staff in your practice. However, bear in mind it takes a journey to get there. Patience is key.

Contrary to fee-for-service, value-based reimbursement is tied to quality over quantity. Because of this, it’s important to take a forward-looking view of quality measures, analyze results through this lens and recognize progress. Clinical efficacy will depend on your ability to foster a quality-based practice culture today, with faith that it will have a meaningful, positive impact tomorrow – both health-related and fiscal.

Set practice wide goals
It’s crucial to set goals everyone in your practice clearly understands. In order to move away from the fragmentation associated with fee-for-service, take an introspective look at your organization and decide which areas could be integrated to lower costs and/or enhance coordination of care. Your goals start here!

Once again, partner resources are also available to help set goals and monitor progress. Staying with our same example from earlier in the article, Humana offers technology tools to practices to better understand care-related data and leverage analytics to improve care in patient-centric way.

Anything worthwhile takes time, and transitioning to value-based care is no exception.

Our Focus Solutions team is here to support your practice as you navigate this healthcare industry shift. We’re the partner you can count on to help make your transition to a value-based model a success – this includes balancing the patient experience with the sustainability of your practice’s financial picture.

If you missed the prior installments in this series, please catch them here.

Our Focus Solutions team is always here to help. Give us a shout!