How to Implement a Transformation of Value Based Care

The Transformation of Value Based Care in the healthcare industry is one that is long overdue. Though value based care has been introduced for a while now, not all healthcare organizations and medical practices have been able to get on board with it. So value based care has become more of a buzzword than an actual thing that is being practiced. This, of course, puts a strain on the credibility of the healthcare industry. Achieving value based care should be at the forefront of the goals of every healthcare organization and medical practice and only by this can the gap between just words and actual action be closed. Luckily more and more organizations are starting to edge away from fee-for-service towards value based care so hopefully, in the next decade, Transformation of Value Based Care will be more significant and more widely spread across the industry.

 

Evidence of Transformation of Value Based Care

Transformation of Value Based Care

Now saying medical facilities and healthcare organizations should move towards value based care is not just blowing hot air backed by no evidence. There is more than enough evidence that shows the Transformation of Value Based Care has many benefits to healthcare organizations. ORC International conducted a study which showed that value based care has helped reduce unnecessary medical cost by an average of 5.6% and this number is expected to rise. When this research was further broken down, the following results were gotten

Reduction in Medical Cost: 5.6 percent

 

Transformation of Value Based Care and Risk Management

Risk management is very relevant to care delivery and plays a big role in healthcare. Proper risk management means patient stratification in all pertinent categories that go being just age and sex. Patient stratification should also include variables like socioeconomic factors, medical history, etc. I say this because the social determinants of health can lead to data-informed risk-stratification which leads to better quality of care. For example, just by looking at social determinants, healthcare organizations can determine how much monitoring and assistance a patient needs after admission. It also means the healthcare organization can identify areas ina city that need more attention and thus attempt to provide care to those areas even if it means going to them through services like mobile clinics, pop-up clinics or patient pick-up and drop off.

How to Achieve Transformation of Value Based Care

Transformation of Value Based Care

Achieving a Transformation of Value Based Care is not a job that can be done overnight. It takes teamwork, brilliant strategies and a long term plan that would help the healthcare organization adjust. Before a healthcare organization starts to implement value based care, they should consider the following factors listed below and ask themselves specific questions.

Sharing Clinical Information

Practicing value based care means being able to share clinical information with other healthcare organizations. When healthcare organizations and medical practices can effectively share healthcare information and data, then they have completed one of the first steps towards value based care. This is because share data means more ease at coordinating care which will help minimize the impact of chronic diseases on patients. Luckily there are lots of software programs and technologies that make collaboration easy and their availability encourages data sharing and coordination. Say health record software have an extra functionality that with the click of a button increase data sharing, then healthcare personnel will be more inclined to share data because the process has been streamlined.

Analyzing Financial Data

In value based care, performance can be evaluated using quality measures that are based on clinical outcomes and are also process oriented. This requires administrative tools that enable the seamless coordination of care and also the collection of payments and reimbursements. This means that the billing complexities can be properly managed and payments can be maximized. For example, a financial data analytics tool could offer analytical capabilities in the form of identifying vulnerable populations which can then lead to a proactive care team being assigned and this will ultimately result in improved outcomes and more engaged patients.

Care Coordination

Speaking of engaged patients, care coordination can be properly managed to maximize the positive impacts of patient engagements and reduced readmission rates. A proper patient care team will always identify gaps in patient care and follow up with customized care plans and care delivery. This ultimately leads to increased patient satisfaction.

Transparency

Transformation of Value Based Care

Value based care requires transparency, innovative methods of reimbursement require transparency and this is not always easy to get. Payers and healthcare organizations can be quite careful when it comes to sharing information and this can be detrimental to the forward momentum of the healthcare industry as a whole. Data sharing and trust much be achieved for the potential of value based care to be reached and for the transformation of value based care to the achieved. There are rules that must be followed when implementing value based care and these rule must be followed and adhered to. Value based care should be about honest and constant communication. This would lead to healthcare organizations being always armed with the right tools to fix any problems should any issues occur.