Finding Success with Value-Based Payment Models

Home-based care and hospice providers know there is risk involved with value-based care. The word itself can lead to some hesitancy. But as the saying goes, “No risk, no reward.”

New payment models are moving away from fee-for-service and towards payments based on outcomes. It’s becoming evident that this will be the way things are done in the future. Preparing now for a value-based payment future will help organizations grow, maintain stability and find success.

There are five steps providers can take to achieve success with value-based payment models:

1. First, it’s important to understand that in a value-based world, data is key. Being an informed provider starts with
            having key information. Without it, total care is out of reach. You must be able to measure performance and show
            positive outcomes to your payers. Data that’s on clear display can help show you where your organization is
            in relation to your goals.

2. A value-based future is one that is digital. That means you’ll want to speed up digital transformation across every area of your
            organization, by automating processes and eliminating manual work that can cause errors. While this may require you to re-think
            your investment in technology, doing so can improve quality, outcomes and efficiencies.

3. Another key to value-based care success is reducing referral response times. Referrals become your lifeblood in a value-based,
            consumer-driven future. The quicker you can admit a patient, the quicker you’ll be able to collect revenue for that patient.
            In order to become the provider of choice to your referral sources, you need to be easy to work with and deliver
            proven quality care.

4. A fourth factor of success is effectively managing patient populations. According to Numerof’s State of Population Health survey,
            98% of healthcare executives think it’s important to their future success. But only 31% believe they are at least very prepared to
            accept financial risk for managing patient populations. You need to be able to stratify high-risk patients, matching them to the
            best care intervention and be able to track outcomes. That requires a fluid exchange of information across care teams.

5. Finally, the fifth success factor in a risk-bearing model is optimizing staff assignments for timely care. The best care for your
            patients is dependent on how fast your caregivers in the field can respond. Field staff must be able to get to the patients’
            homes quickly and administer the right care. When schedulers can view a grid and get a bird’s eye view of where all field
            clinicians are, patient care is expedited, and the risk of an ED visit is reduced.

One option to help meet these five factors is an integrated platform approach. Generally, providers view the EHR as the operating system of healthcare, but it’s important to think beyond that. When every area of an organization is digitized with technology solutions that work together, you gain greater efficiencies, easier and reduced costs of care. What’s more, silos of information are torn down and data sharing becomes effortless, which is essential to better patient care.

Right now, home-based care providers must make a choice: Will you take on financial risk or risk being left behind in this new value-based world? A strategy that may have worked for years may not be the answer going forward. The future of post-acute care won’t replace the power of human interaction, but rather add the best of technology and digital tools. As payer networks begin to push away those who underperform, it’s important to ask — do I have the right strategy and technology to succeed.

Originally published on McKnight's Home Care