The good news is there is a clear line of sight on what it takes to achieve value-based healthcare, and the challenges are surmountable.
1. Changes have real impact on patients
Cornerstone Health Care in North Carolina began their value-based transition in 2012. According to AMA Wire, after four years, they now have enough data to report on the impact of their programs on patient care:
“Cornerstone now has six specific care models to address their most vulnerable patient populations, and since implementation, they have seen positive outcomes resulting in an overall cost reduction of 12.7 percent and a 30 percent reduction in hospitalizations across all programs. They also have increased satisfaction among patients and healthcare professionals by 43 percent, and they have a quality score of 94 percent, ranking them sixth in the nation for quality in 2014 in the Medicare Shared Savings Program.”
They achieved these results with unrelenting focus on their patients. CEO and President Grace Terrell, M.D., focused efforts in their transition by framing them with the following question: “What resources do we need to make sure that the patient has the best possible outcome at the best possible price for the best possible quality?” Your own transition will be well served to use this question to keep your processes on track.
2. Use communication and system interoperability as a tool to facilitate transition
Health systems are constantly looking for ways to improve patient outcomes by intelligently using and sharing data. In a recent blog post for the Healthcare Financial Management Association, Karen Ignagni, President of EmblemHealth, explains how the value-based care transition affected her organization’s communication:
“Clinicians working in partnership with health plans gain access to innovative new programs that provide data in support of their efforts to identify disparities and to better manage the health of their patients. In partnership with health plans, physicians and hospitals receive real-time information that helps them improve care coordination and identify patients who need follow-up, reminders to fill their prescriptions, checkups, or testing.”
Being able to share and consume data on both a human and a system level lets everyone access a longitudinal health record, which facilitates the delivery of more quality care to patients.
3. We’re halfway there
In a previous interview for the Focus Ahead blog, Andrei Gonzales, M.D., Director of VBR Initiatives at McKesson Health Solutions, sums up the progress: “The good news is there is a clear line of sight on what it takes to achieve value-based health care, and the challenges are surmountable.”
That statement is consistent with the response to our study, Journey to Value: The State of Value-Based Reimbursement in 2016, where providers say they are 50 percent along the continuum from fee-for-service (FFS) to value-based reimbursement (VBR). You might think that being only halfway there is discouraging rather than hopeful, but what that statistic means is that you’ve finished the difficult groundwork and it’s time to start building momentum.
The shift from volume to value is well underway. The stories above illustrate how some early adopters embraced the change and are now delivering results through their focus on patients, and open, standards-based systems that facilitate communication.
This post originally published on September 29th, 2016 in the Medical Imaging Talk blog.
For more ideas and resources to navigate value-based care and reimbursement, download our new, free ebook: The Value Mandate.