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Health Plans and Physician Practices Working Towards Value-Based Care

Healthcare is shifting more and more towards value-based care models which is vital because when doctors can focus on quality care instead of quantity of care, everyone benefits, especially the patient. However, too often, independent physicians are bogged down by issues involving the general management of the practice. They also face cost barriers when looking to upgrade technology or systems. It is because of this that health plans like Blue Shield of California are partnering “to support physicians in moving toward value-based care by investing in their practices.”

With technology improving at a staggering pace compared to twenty years ago, it is difficult for physicians to go at it alone while affording to remain current. Furthermore, pressure on independent practices comes in the form of administrative paperwork due to requirements in the Affordable Care Act and with CMS. Large healthcare organizations and hospitals have entire departments to handle billing, paperwork, IT services, and more. For small independent practices, that extra workload is piled on the current staff at the end of an already long day. Hiring additional staff to handle the increased workload becomes cost-prohibitive when you consider that the cost of doing business increases each year while insurance payments typically remain unchanged for many years. Because of these difficulties, many physicians are moving away from independent practices to healthcare groups that can take on non-care related tasks.

The shift in how care is delivered is happening in several different ways.

Telehealth and health hubs like the ones you see at drug stores like CVS are attempts at providing more efficient, quality care designed to meet the needs of today’s consumer. In the case of Blue Shield, they “created Altais because fewer and fewer doctors are staying independent. Physician practices are burdened by administrative work and sometimes can’t afford to upgrade their technology or acquire tools to succeed in new payment models,” said Dr. Jeff Bailet, Altais’ CEO and former executive vice president of healthcare quality and affordability at Blue Shield in the article.

The benefits healthcare providers can offer are significant.

‘Tools include population health support, predictive analytics, as well as tools that reduce burden by providing a real-time transcription of a patient visit, for example,” the article continues. “Altais will also help with back-office functions like billing and credentialing.”

It is easy to see why this new direction for physicians is so attractive.

“In many ways, physicians are feeling the same pressures that mom-and-pop stores on Main Street have already been through, with the influx of mega-corporate stores that took place over the past 40 years and changed the way Americans shop. These pressures are leading to burnout for some physicians,” says Dr. Ripley Hollister, a family medicine doctor in private practice in Colorado Springs, Colorado.

Is your practice being stretched to the max due to administrative workload and more? If you are looking at new ways to streamline your practice and get back to what you do best, we can help. Sunlit Cove Healthcare can help you decide what is best for your practice and help you implement the new changes. Give us a call to get started.

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Sunlit Cove Healthcare Consultants

We provide management and consulting services to help healthcare businesses run efficiently. Navigating the dynamic and complex revenue cycle management is a challenge for many health plans, health care vendors, and providers. Our consulting services are available to assist with your day-to-day operations and provide expertise in growth and change management. We manage all aspects of your enterprise from the development of the revenue cycle management process to the completion of your business cycle.

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