National Physicians Week is a great time to reflect on all the hard work you do every day to support patients’ health and wellness. It’s a time to consider your dedication to patient-centered care and what the shift to value-based care means in the health care sector. A recent study suggests those of you engaged in value-based care have an extra cause to celebrate.
According to research published in JAMA Network, providers in value-based Medicare Advantage models achieved better care quality across eight different metrics than their fee-for-service counterparts. Among the quality care metrics measured, patients under value-based care models had:
- 18% lower odds of hospital admission, demonstrating effective population health management.
- 14% lower odds of an avoidable emergency department visit, a reflection of improved care coordination and integration.
- 9% lower odds of 30-day hospital readmission, underscoring the importance of chronic care management and care coordination.
Metrics such as these helps validate the positive impact of value-based care—undoubtedly contributing to providers’ increased appetite for value-based care overall. However, if you are like a lot of physicians, adopting value-based care is less a question of “why” than “how.”
Fortunately, every step you take can help you gain valuable experience without upending your practice or organization.
Why Has it Been Hard to Shift to Value-Based Care
Transitioning to value-based care has been challenging primarily due to the ingrained nature of the fee-for-service model in health care systems. This traditional model often emphasizes quantity over quality, creating a barrier for the implementation of patient-centered care and performance-based incentives. Additionally, the shift requires significant changes in health care payment reform, including risk-based contracting and accountable care organizations (ACOs). These changes demand new infrastructures, such as advanced health information exchange, and a cultural shift among providers towards outcomes-based reimbursement. The complexity of integrating care coordination with existing systems also presents a challenge, alongside the need for robust health care cost reduction strategies and consistent patient engagement in value-based care.
Take Big Strides: Four Steps for Physicians to Take in a Value-Based Care Transition
There is no question that the shift to value-based care is a big one. As we ruminate on continued positive change during National Physicians Week, consider these four steps you can make to ease your growth in value-based care:
1. Lean hard into supportive relationships to focus on patient-centered care.
What happens to your patients after they see you? The ability to support patients throughout the continuum of care is crucial to value-based care success. That requires you to strengthen relationships and close loops with primary care and acute care providers, specialists, payers, ancillary services, and others. So, think about your referral network. Approach the organizations in it with the goal of creating a more connected data flow that helps everyone deliver more seamless patient-centered care.
2. Dig into multi-source data.
Value-based opportunities and performance hinge on your ability to get, analyze, understand, and act on the data. At a bare minimum, you must have the means to transform your electronic health record (EHR) data into actionable insights at the point of care. Ideally, those insights will incorporate data from beyond your EHR as well—from labs, hospitals, other providers, payers, etc. You may need to double down on your technology partnerships.
3. Strengthen care coordination/care management.
Data is also key to enabling care teams to identify and reach your most frail patients. Care coordinators embedded into your care teams, for example, could use data to identify gaps in care and then reach out to providers and patients alike to ensure the gaps are closed.
4. Focus on whole-person health.
Social determinants of health (SDOH) and health equity are continuing to gain recognition for the game-changers they are. In fact, CMS has made health equity a cornerstone of its ACO REACH model. So, think about partnerships that could help maximize your impact on your patients, for example partnering with community-based organizations (CBOs). Collaborating with CBOs for a holistic approach can maximize patient engagement with value-based care.
Value-based care models typically encourage health care organizations to develop the infrastructure, focus, and processes needed to drive better patient health outcomes. For most physicians, this kind of chance to improve people’s lives is exactly what we celebrate during National Physicians Week. So, let us all continue to look for the steps we can take to make a big impact on patient care.
To learn more, contact us today. Or, explore our resources library for more guidance and perspectives on value-based care.