Unlike the fee-for-service model, which incentivizes providers for volume, value-based care programs focus on treatment results. This is important because it reduces the cost of healthcare by preventing complications and disease progression. However, transitioning to a value-based care model can be challenging for many practices. One of the major challenges is the need for interoperability between disparate systems that store clinical data, electronic health records, provider network data, and more.
Cost
In contrast to traditional fee-for-service models, value-based care incentivizes healthcare providers to focus on the outcomes that matter to patients. This includes lowering overall health costs by encouraging doctors to be more thoughtful about the tests and procedures they recommend, which can save patients money in the long run. Patients worried about the high cost of medical treatment may delay seeking help until they feel overwhelmed. Still, a value-based approach can encourage them to seek care earlier and stay engaged with their healthcare providers.
In addition, value-based care solutions are designed to promote financial stability for healthcare organizations by tying payment to outcomes. This can encourage providers to invest in new technologies and practices that can improve patient outcomes while reducing costs. This can lead to more effective healthcare and a healthier population. However, as with any new model, a successful transition to value-based care requires careful planning and the right technology. Small clinics, in particular, need to make sure they have the right tools for this change, including an EHR system that promotes collaboration and emphasizes data analytics and reporting.
Quality
Value-based care aims to decrease medical errors and improve overall healthcare outcomes. With an increased focus on preventative measures, patients should experience fewer unnecessary tests and treatments. In addition, fewer hospitalizations and other medical emergencies should occur, resulting in overall healthcare cost savings for insurance sponsors.
For physician groups, the transition to value-based care could lead to greater scrutiny by investors seeking to evaluate their operational sophistication. To realize material savings, groups may need clear and comprehensive clinical pathways that address members’ needs and a disciplined clinical staff immersed in a common approach to care delivery supported by analytical insights.
Physicians may also spend more time and effort on documentation to support a member’s severity of illness, which could take away from patient interaction and care. With the growing threat of burnout among physicians, all stakeholders should carefully monitor this trend toward more data collection and less face time with patients. For value-based care, the right software is essential for both payors and providers to manage the transition effectively. It allows payers to quickly deliver value-based care measure metrics and streamlines value-based contract management. It helps providers automate care coordination workflows based on specific triggers and requirements.
Efficiency
The shift to value-based care requires a change in strategy and the right software. Small clinics must look for software that promotes collaboration, emphasizes analytical reporting, and facilitates integration with existing third-party hardware and software. Those who adopt this type of software will be much more prepared for the future of healthcare. In the past, a fee-for-service model encouraged physicians to perform many unnecessary tests and procedures on patients to earn reimbursement. However, when a patient is diagnosed with a chronic illness, it’s crucial to provide quality care as efficiently as possible to reduce costs and improve health outcomes. A value-based care system is the best way to accomplish this goal. Value-based care systems reward providers for providing better outcomes per episode of care, ultimately reducing costs. Providers can also take on a shared risk by participating in bundled payments. Bundled payments predetermine the total allowable acute and post-acute costs for an episode of care. Providers can take on upside risk in these programs to gain revenue if they exceed the target cost and achieve quality and equity targets.
Patient Engagement
When fully engaged with their healthcare, patients are more likely to follow doctors’ recommendations. That includes visiting the doctor regularly, avoiding certain foods or activities, and other lifestyle habits learned from interactions with their physician. This adherence can lead to healthier patients, lower costs, and better health outcomes. However, many healthcare practices struggle to keep their patients engaged.
One of the main reasons for this is that healthcare practices must provide patients with more information. Another reason is the need for more tools to support patient engagement. Fortunately, recent technology advancements have made it easier for healthcare practices to implement patient engagement-based care models.
With these new technologies, healthcare practices can provide patients with more timely and relevant health information, including a clearer view of their care. Furthermore, these patient engagement-based care systems allow physicians to focus on the needs of their patients while still delivering quality healthcare. A patient engagement-based care system integrated with a medical practice management solution can improve client satisfaction, staff efficiency, business growth, and health outcomes. It can also help healthcare practices reduce readmissions and redundant tests, speed up patient payments, increase adherence to care plans, and more. However, it is important to start small and build up your patient engagement-based care program gradually. Choose a patient group to work with first, and then expand your pilot program as dictated by the success of your initiatives.
