In the past, there was one way to run a medical practice: provide a service and receive payment. Today, more and more providers are turning away from the fee-for-service method of doing business to a value-based reimbursement strategy. There are a variety of government and private models that allow doctors to take this approach, unite with other providers and ultimately improve the quality of care they provide their patients.
Rather than focusing on getting more patients in the doors (increasing quantity), value-based reimbursement places the focus on improving the level of care for each patient (improving quality), reducing overall costs and providing preventative care education to help people avoid trips to the doctor or hospital.
Practices that adopt the value-based system must track and report on the overall health quality of their patients and the population in general. Data analytics are the wheels of the system, allowing doctors to demonstrate how their services have positively impacted the community. Coordination with upgraded IT software programs, patient engagement and community education ultimately result in rewards for the practice.
If your practice is considering taking a value-based reimbursement approach to care, there are some factors to consider:
- Your practice may need to increase your staff to handle the administrative tasks of information-gathering and reporting.
- The medical billing process will be impacted so your practice will most likely need to update your system.
- In the initial stages, it may be difficult to forecast revenues accurately.
- An investment in automated technologies will be required.
- Your entire management team must all be on board with the change and be willing to invest both time and money to implement it correctly.
- All of the doctors in the network must have common goals and be rewarded for meeting those goals.
- Training will be necessary for the entire staff.
- A great deal of pre-planning and strategizing will be necessary, including a transitional plan, operational plan, health service assessment, software implementation and much more.
- There must be a willingness to work closely with other providers in the network to deliver comprehensive care to the community. This includes frequent communication among providers.
- Testing and re-adjustments will be necessary to hone the program and make it as effective as possible.
Quality Method Must Still Provide Results
It is important to remember that in the process of moving to – and completely implementing – a value-based reimbursement system, your patients must continue to receive the very best care possible. You want to make sure you are not underserving patients simply by implementing one method of care over the other. Measures must be in place to ensure that the entire provider network is working toward the common goals of improved patient care, quality of services and efficiency of treatments.
Help for Value-based Reimbursement Planning
Moving toward this system is not without challenges. Most practices need an outside resource to lead them through the steps of analyzing, planning and implementation for any comprehensive system. Advantage Healthcare Consulting, a division of Advantage Administration, is a Management Services Organization (MSO) that has partnered with organizations that offer many types of services and have been specifically trained in this cutting edge new form of service system. By joining the MSO, your practice will have access to high quality services at the best pricing available. This is because our services are bundled together so we can achieve high-volume pricing for any size practice.
To learn more about our options, contact Advantage Healthcare Consulting today.