How to Succeed in Moving to Value-Based Reimbursements

How to Succeed in Moving to Value-Based Reimbursements

We have covered the top three challenges in moving to value-based payments in this article: Top Three Difficulties in Moving to Value-Based Payments.

Here is what the healthcare system should master in order to stay profitable during the process of transitioning to value-based reimbursement.

1. More patients

Healthcare systems will not be able to increase patient volume overnight; it will be a gradual process. As the facilities improve their care, the payers will award the high performers by including them as premier healthcare providers in their network.

2. Shared Savings

Quality improvement will become crucial to achieving management proficiency of shared savings. The ultimate positive effect of shared savings management can increase revenue, improve quality and lower costs to deliver healthcare.

3. Infrastructure

Streamlining and organizing the systems, processes, and procedures will lower costs in any situation. The benefits will go the back to the healthcare system, not the payer. Relevant software infrastructure that tracks all required data elements will assist in a positive quality improvement result.

4. Ability to adapt

Healthcare systems will have to pivot their strategies when faced with not meeting their financial goals. The real test will be in how quickly can they adjust their healthcare delivery system model.

5. Innovations

Promoting innovations, new ideas, and new ways of thinking will be instrumental in staying ahead of the financial curve.

6. Cost

Healthcare systems must know the true cost of care. They will have to go beyond revenues and expenses to manage risks and understand what it requires to deliver services across the spectrum of care.

In conclusion:

It is absolutely possible to stay profitable while utilizing value-based care. Healthcare systems need to understand their targets and the steps and resources required to achieve them.

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