Ease the Shift to Value-Based Care with Proven Population Health Tools
The shift from fee-for-service to fee-for-value is undoubtedly daunting for providers. The value-based care model has thrown a wrench into how hospital systems get reimbursed for healthcare services and providers are now tasked with delivering a higher quality of care at a lower cost. Quality measures are set high and many providers and health systems are struggling to meet the necessary scores. For some, the dark cloud of lower reimbursements and financial penalties could be on the horizon.
As provider groups work internally on this complex transition, they should consider partnerships with existing population health companies with tools and that will help them achieve these quality measures and work toward achieving the Triple Aim of lowering costs, improving the patient experience, and improving the health of their population.
Embracing a combination of new and old population health management resources can help expand patient access to high quality care at a lower cost. Peter Goldbach, M.D., Chief Medical Officer of Health Dialog, recently wrote an article: “3 Strategies to Help Your Organization Make the Shift to Value-Based Care.”
A summary of Dr. Goldbach’s strategies for consideration:
Expand Care to Patient Communities: Rather than recruit additional PCPs and build more provider offices, explore opportunities with experienced health centers in your network’s neighborhood. Partner with pharmacies, urgent-care, and convenient-care clinics so your patients have more access to in-network care. These centers have begun to offer medication management and chronic care management services as well, which could lead to improved patient outcomes and make a big financial impact.
Leverage Population Health Program Analytics & Reporting: Many population health programs focused on helping high-risk, high-cost individuals improve self-care and have resulted in more appropriate use of care and fewer hospitalizations through health coaching. Today more advanced analytics and reporting can be used to look at the management-level detail on cost, utilization, and disease progression, which also allows for earlier interventions for those at-risk for costly chronic conditions (such as pre-hypertensive and pre-diabetic individuals). Programs that also use shared-decision making principles and tools help engage patients in their care and empower them to make decisions that are right for them.
Use Telehealth and Digital Health Services: 24/7 Remote access to medical advice is convenient for patients and helps ensure emergency resources are used properly and care is kept in your network. Nurse line resources (phone, chat, and email) are effective and efficient tools for managing utilization and improving the patient experience. Directing patients to the right healthcare setting, helping them make appointments within your network, or providing condition education, leave them more satisfied with their care and help networks control spending.
Exploring one or more of these option will help providers offer more patient-centric care that fits this new fee-for-value cost structure.