Value-based Care

Details to consider in achieving a higher value in value-based care

Value-based care is a form of reimbursement that attaches payments to the quality of care rather than the number of procedures and tests or an annual fee schedule. In value-based care system, the providers are rewarded for both efficiency and effectiveness.

So how do we deliver a higher value?

1. Data

Healthcare organizations must have systems and procedures in place to analyze their quality and financial performance. All this needs to happen in real time so that they can manage risk successfully.

2. Waste

Based on the report from Healthcare Finance:

There are plenty of opportunities to trim waste in America's $3.4 trillion healthcare system. Some experts estimate that at least $200 billion is wasted annually on excessive testing and treatment. This overly aggressive care also can harm patients, generating mistakes and injuries that are believed to cause 30,000 deaths each year.
3. Perspective

In a fast-changing healthcare environment leaders must stay ahead of emerging competition like CVS MinuteClinics, telemedicine and virtual and often offshore healthcare solutions. It takes a great leadership team willing to adapt and embrace the need to change in order to survive.

4. Bundled Payments

Based on Center for Medicare and Medicaid Services  The Bundled Payments for Care Improvement (BPCI) initiative is comprised of four broadly defined models of care, which link payments for the multiple services beneficiaries receive during an episode of care. These models may lead to higher quality and more coordinated care at a lower cost to Medicare.

4. Overall Quality Improvements

Healthcare systems and hospitals must address these critical issues: patient discharge delays, care variation, avoidable medical errors and communication breakdowns between providers. These issues cost hospitals, patients, and families more than only money. It takes a dedicated team to make real improvement stick, especially in a larger system.

It will not happen overnight, but hospitals can improve the quality of care at a lower cost by considering these elements.

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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.

Related: Revenue Cycle Interim Management