Shifting to value-based reimbursement (VBR) is a challenging journey, and trying to proactively manage risk at the same time only makes things more complicated. However, there are simple ways a provider organization can more proactively position their organization for a shift to VBR.
The transition to value-based care is pushing radiology beyond its traditional borders, and success in this new model is measured in better patient outcomes. In order to achieve those outcomes, radiologists and their colleagues in the hospital and referring community need broad access to both data and images. A more integrated, collaborative radiology workflow can connect both systems and people, which helps provide much-needed context for better patient care. Here are four characteristics of an integrated, value-based radiology workflow.
Healthcare organizations nationwide are focused on patient care and health outcomes, and rightfully so, but financial well-being is equally important for you to continue to provide the highest quality care. During HIMSS16, we discussed the importance of financial health on the road to value-based care, including sharing our experience developing and implementing value-based payment models for physician, hospitals and payers and providing claims management solutions for the acute and non-acute provider markets.
When it comes to navigating the transition from fee-for-service to value-based care, we all see what the destination needs to be; however, for most organizations, it’s not exactly clear how to get there. The road ahead is foggy.
It’s no secret that hospitals and health systems are more challenged than ever to deliver value-based care and a positive patient experience — and that doing so has both clinical and financial implications. Watch this three-minute video: A First Step on the Journey to Improving the Patient Experience, to see how the right remote patient access solution improves patients’ experiences as well as hospital and health system productivity, efficiency and effectiveness.
That sound you’re hearing is the shift of vast resources from the traditional fee-for-service payment system to alternative models organized around value, quality and lower costs. The Department of Health & Human Services (HHS) has set a goal that 30% of Medicare payments be tied to value by the end of 2016, and 50% by 2018. In 2014, that was about $362 billion, according to a report in Modern Healthcare.
When I’m asked how the transition from volume to value-based health care is going, I joke that it’s like navigating a river with Class 4 rapids while straddling two canoes. But the shift has seriously affected the way I think about patients.
According to a 2015 American Hospital Association (AHA) survey, 64% of respondents reported participating in the Centers for Medicare and Medicaid Services (CMS) Bundled Payments for Care Improvement Initiative or a CMS Shared Savings Accountable Care Organization (ACO). The survey, which was conducted by KPMG and administered to attendees at the AHA Leadership Conference, also revealed that 53% of the hospitals were pursuing bundled payments or an ACO arrangement with a commercial payer.
In 2015, value-based care (VBC) continued to dominate our healthcare headlines. Clearly, the transition to VBC is going to result in fundamental changes in how healthcare is delivered, how healthcare is reimbursed and how patients interact with the healthcare system. In other words, it has tremendous implications for each of us because we are all, in one way or another, constituents of the healthcare system.
The regulatory changes facing providers shift constantly yet always raise the demand for better clinical outcomes, safer care and improved patient health status all at less cost. Whatever direction-changes the future holds, providers can be successful by mastering four skills.