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How to Transition Your Practice to the Value-Based Care Model

| October 19, 2020

How to Transition Your Practice to the Value-Based Care Model

In 2008, The Centers for Medicare and Medicaid Services began emphasizing value-based care over traditional fee-for-service models. At the time, CMS noted that its goal was to “reward health care providers with incentive payments for the quality of care they give to people with Medicare.”

Conceptually, value-based care makes a lot of sense. It encourages medical providers to achieve better health outcomes for their patients and results in lower hospitalization rates, lower fatalities, and improved quality of life as a whole. Unfortunately, for many providers, transitioning from FFS isn’t easy.

What is FFS?

FFS incentivizes medical providers to see as many patients as possible. A doctor can charge a single fee for an appointment and additional fees for other services provided, such as diagnostic imaging, laboratory tests, preventive screenings and more. From a financial standpoint, FFS makes it possible for private practices, hospitals and health systems to maintain a steady income.

However, the FFS model has unintended consequences. Most notably, it focuses on volume instead of value. As a result, many patients who receive care at FFS-based practices feel rushed during treatment. Instead of setting aside plenty of time to understand an individual’s unique needs, many FFS providers stick to a strict schedule that only allows for brief, impersonal consultations.

What is Value-Based Care?

As previously mentioned, value-based care is a reimbursement model that pays providers based on their care delivery and the quality of care provided. The better a practice’s patient outcomes, the more money they make. Instead of rushing through consultations, value-based care allows for care coordination, meaning patients are given the right care, from the right provider, at the right time.

Common Challenges of Transitioning to Value-Based Care

Over the course of the last decade, a growing number of private practices, hospitals and health systems have made the transition to value-based care, but it isn’t without challenges. Many providers report five difficulties, in particular:

  1. Lack of resources
    In order to provide value-based care, a medical practice needs to be fully staffed. With many organizations facing huge budget cuts because of the COVID-19 pandemic, this isn’t always possible. As a result, providers and their teams must take on even greater responsibilities. This increases the risk of burnout and can also negatively affect morale.
  2. Technology and interoperability challenges
    In order for medical providers to reap the rewards of value-based care, they need to be able to share patient information with specialists like drug addiction counselors and mental health advocates. Unfortunately, many of today’s electronic health records systems are clunky or unable to integrate seamlessly with other software platforms. As a result, valuable patient information often falls through the cracks, making it difficult to successfully coordinate care.
  3. Unpredictable revenue streams
    Value-based care models are great in concept, but there’s not one single blueprint that every medical practice can follow. For a provider to successfully transition from FFS to value-based care, they have to plot their own course. This is both exciting and time-consuming — so time-consuming that many providers give up before seeing the rewards of their labor.
  4. Constantly changing policies and regulations
    The Centers for Medicare and Medicaid Services is constantly tweaking and updating guidelines for value-based care models. In order for medical providers to receive the reimbursement they need to stay in business, they must stay abreast of these changes and implement them as quickly as possible. Failing to do so can result in penalties, fines or lengthy legal battles.
  5. Difficulty collecting and structuring data
    To successfully implement a value-based care model, medical providers need to be able to review patient and operational data and make sense of it. Quality data can highlight inefficiencies or needless expenses, that a provider can then tweak to achieve better outcomes. But without an easy way to collect and interpret the data, this isn’t possible.

How does Med USA make the transition to value-based care easier?

At Med USA, we have more than 40 years of experience helping physicians manage their practices. In terms of value-based care, our MedPrime EHR platform makes it possible for private practices, hospitals and health systems to manage all aspects of their operations. What’s more, we offer the program at a flat cost with no hidden fees. When you invest in MedPrime EHR, you automatically gain access to the full suite of features, including:

  • Review of open and closed notes
  • Arrived patient alerts
  • Messages
  • Laboratory testing statuses

The system is intuitive and easy to navigate, and allows for data sharing across multiple platforms. This cuts down on administrative tasks and ensures each member of a patient’s care coordination team has access to the data they need.

Our services don’t stop there, though. We offer several other platforms that can assist in your transition to a value-based care model, including revenue cycle management, medical credentialing, medical billing and even specialty services for urgent care practices.

If you want to make the transition to value-based care but have been holding off, now is the perfect time to take action. To learn more about how we can assist you in these efforts, talk to one of our practice management experts today!

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