Maximizing value-based care

The transition to value-based care (VBC) can be tricky. Success depends on organizational stakeholders’ ability to collaborate to reach the goals set for them. Despite the Department of Health & Human Services’ (HHS) aim to convert 30 percent of fee-for-service (FFS) Medicare payments to value-based payment models by the end of 2016 only one third of physicians believe the healthcare system should transition to value-based care.

There’s clearly still a sense of skepticism when it comes to making this transition. The opportunities that VBC models bring, however, offer benefits that are worth exploiting. Let’s look at some ways providers can work to maximize value based care:

1. Find revenue leaks: According to Marc Lion, CEO of Lion & Company CPAs, the average practice has a 10-15 percent profit leak. While these leaks can be the result of several factors, a major one is debt management. Reducing bad debt by just two percent can deliver tens of thousands of dollars to the bottom line of practices.

Payment methods can also make a difference. Almost 85 percent of providers preferred to receive payer payments through electronic funds transfer or electronic remittance advice, even though 89 percent had received paper checks and explanation of payments from one or more of their payers. With increasing patient responsibility, healthcare organizations must work to optimally manage revenue cycles with a view to gaining more input from consumers. Additionally, they can reduce bad debt management by:

• Helping patients get insured and reducing self-pay patients.
• Streamlining patient financial clearance to accurately understand and explain benefits to patients before delivery of care.
• Maximize reimbursement for each episode of care by making sure payers meet negotiated, contracted reimbursement rates.
• Efficiently collect payments.

• Provide periodic staff training to ensure they know what is expected of them
• Establish standard policies to make sure nothing is missed
• Ensure constant checking and rechecking to avoid reworking

• Simplifying data preparation for exploratory analytics which makes data useful more quickly and easily than traditional solutions
• Increasing productivity by reducing time required to sieve data and facilitate better utilization
• Bringing data directly to analysts reducing the workload on the internal IT infrastructure
• Improving organizational data usage

• Price transparency is considered one of the ways to stabilize health care cost. However, transparency is not possible without a system to collect, organize and present price reporting to employers and employees.
• Greater patient interaction helps measure patient satisfaction and stresses on the need to increase consumerism in healthcare. Smart healthcare providers will do everything in their power to secure patient satisfaction. Embrace the emergence of omni-channel interactions to improve workflows and deliver a more positive patient experience.
• Comparative performance measures data can help reveal important and relevant information. Physician leadership can help physicians be the champions of the performance assessment component of program by making sure physician can dig deep into the data, develop confidence in its findings and understand what precisely needs to change.