Expert Perspective

March 27, 2023

4 Steps Toward Value-based Care for Physicians

Joe Nicholson, DO - Chief Medical Officer

National Physicians Week is a great time to reflect on all the hard work you do every day to support patients’ health and wellness. 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 metrics measured, patients under value-based care models had:

  • 18% lower odds of hospital admission
  • 14% lower odds of an avoidable emergency department visit
  • 9% lower odds of 30-day hospital readmission

Metrics such as these help 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.

Take big strides with four steps

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. 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 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 they 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). 

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.

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