Friday, April 21 | Value-based Care

Saving Money and Lives Through Value-Based Care

By Netsmart

It’s no secret that the post-acute healthcare industry is undergoing a revolution to increase successful patient outcomes while reducing the costs it takes to achieve them. The current payment environment is shifting toward the value-based care approach and organizations across the country are working diligently to implement the right steps and the technology to put it into effect.

Many organizations currently utilize a fee for-service model where providers are reimbursed for the volume of patients versus the quality of care they provide. The more they do, whether its seeing patients, ordering tests or performing procedures, the more money they make. There is no incentive for ensuring long-term successful outcomes for patients in this type of model. Its inherent nature doesn’t demand a need for care coordination, which leads to fewer positive case outcomes This is not the best model to succeed where it matters most – achieving optimal wellness for individuals at a lower cost for payers and providers.

Enter Value-Based Care

The adoption of a value-based care model is a shift from episodic care to continuous care. Its underlying principle is simple – improving overall public health through better quality and safety for patients and families, at a reasonable cost for organizations. Essentially, care providers are paid to manage care in the most cost effective location – treating the whole patient and the full episode of care. The incentives are tied to keeping people healthy and improving the health of individuals who have chronic or comorbid conditions in a cost-effective way. In a value-based care environment, organizations must work together to coordinate care effectively and assure the right care transitions occur at the right time.

Building and implementing cross continuum care plans is the core component of preparing to make the shift to value-based care. Implementing technology to drive these plans requires the right electronic health record (EHR) which includes a proactive care management module.  You need more than a traditional EHR system to capture data and monitor the care provided.

Strength in Numbers

As your organization moves to a value-based care model, a simple EHR isn’t enough. Acute, post-acute and behavioral healthcare providers are banding together to access the full benefits of an integrated EHR. Potential partners are looking for connections who have robust EHRs with proven data exchange and reporting capabilities as well as connectivity to support a larger network that drives value-based care. They are also looking for organizations who show a strong history of reporting positive care outcomes. Considering that less than half of post-acute facilities can currently send data to other providers, the time has never been better for organizations to join the club and go digital.

As part of these integrated care communities, care providers will be asked to assume risk and be accountable for outcomes. It’s time to get ready, it’s time to implement the technology required to maximize efficiency and facilitate coordinated care.

Connectivity with partners is essential to establishing a presence on the value-based care playing field.

The key to forming the right partnership is being proactive. Take time to find the role your organization plays in the bigger picture and begin establishing networks in your region with those who already have the right tools to proactively manage their population’s care.

To enable this collaboration, Netsmart recognizes it takes more than an EHR, it takes a comprehensive technology platform. That’s why we created a robust, affordable interoperability network designed specifically to connect post-acute care providers with local health systems and other community providers.

Most Important Question

At a time when lowering costs, improving outcomes and increasing patient satisfaction are more important than ever, ask yourself, “What is my organization’s risk tolerance? Do we have the tools in place to appropriately manage it?” Click here to watch our latest webinar with Netsmart EVP, Corporate Development Kevin Scalia and Strategic Advisor Pamela Pure where they focus on value-based care in the post-acute world. Learn more about what it is, why it’s important and how your organization can be a part of an important and necessary shift in the way we approach healthcare.



Meet the Author

Netsmart - color - PNG
Netsmart ·

From the CareThreads Blog

Webinar Recap: What’s Next for MCOs After EVV Compliance

Wednesday, September 28 | Value-based Care,Thought Leadership

As the upcoming EVV compliance timeline is quickly approaching, we thought it would be interesting to discover how the initial phase and implementation of EVV has affected managed care organizations (MCOs), and their provider networks. This blog recaps a recent Netsmart webinar that addressed the details of this topic with the talented Dr. Melissa Berdell, Director Fraud, Waste and Abuse at Highmark Wholecare.

CareThreads Blog Stock Image for SiteCore (370 × 158 px) (1)

Part 5: Current State of Peers in the United States - Demographics and Economic Impact

Monday, September 19 | Human Services,Thought Leadership,Value-based Care

In our most recent blog, The Role of Peers and Mutual Support in Alcoholics Anonymous, we discussed the fascinating history of Alcoholics Anonymous and its contributions to today's health care continuum. Evolving in parallel to the mental health peer movement, AA and its affiliate organizations, e.g., Narcotics Anonymous came to identical conclusions about the unique value of mutual support. Join Denny Morrison, as he unpacks how often peers are used, how they are credentialed and how they affect the economics of health care in the United States.


Succeeding Under Medicare Advantage: What Home Health Agencies Need to Know

Wednesday, September 07 | Thought Leadership,Post-Acute Care,Value-based Care

According to the Centers for Medicare and Medicaid Services (CMS), more than 64 million people are enrolled in Medicare. The fastest-growing segment of the government’s national health insurance program is Medicare Advantage (MA). In case you missed the podcast, hear from Netsmart leaders Dawn Iddings and Mike Dordick join Home Care Technology Report Editor Tim Rowan to discuss demands and strategies agencies can use for success.