The world of healthcare is constantly evolving from the technology we use to new clinical methods and the way we measure and bill for services – and these are only the tip of the iceberg. To stay relevant and up to date in our ever-changing world, we all must continue to grow and develop our working processes. Healthcare is emerging as a growing concern and focal point for transformation in the United States. As a result, our ability to pivot and adapt is even more essential.
Practicing in a fee-for-service business model will soon be a thing of the past as healthcare continues to shift toward a more value-based care approach. And this shift isn’t something to be taken lightly, as the Biden administration has made it a key initiative with funding being allocated towards value-based care initiatives intended to encourage and drive focus on patient-reported outcomes, closing gaps of care and quality measurement.
So, when do you make a move and transition over to value-based care?
Transitioning to a value-based care model seems like a daunting process, and as physicians are still making money with fee for service, some are reluctant to make this change because the workflows used to live in a value-based model can be different than the workflows required to succeed in the fee for service model. Although there’s not a hard stop timeline for the transition for all providers, it’s coming quickly. It’s important to start putting in the infrastructure and systems to track and measure so that you’re prepared when it does come time to get on that ship.
Now, you must be thinking, how do you set up the infrastructures needed while also being on the ground in clinical care as physicians and leaders? To accomplish this, we first need to ask ourselves, what do we value? Is it a set of rules that are sent down from our government? Are we guided by patient preferences for specific treatment and care routes? Or are they rules or measures that the clinicians that take care of the patients put together? And the answer to that is, it’s a combination of all three. Those three groups are all stakeholders and must work together to be successful. This is the best way to deliver measurable, high-quality care consistent across the country, with relevant regional nuances.
The first step is building the foundation
To start, you must set your immediate goals and establish a long-term vision for your practice. You must ask yourself what’s most important when providing care for your patient. As we’re looking at value-based care, we must be careful about not assuming we know what our patients’ value but ask them and try to understand this to shape our care around. And to do this, you need the entire team to come together and make it their goal to provide excellent care and achieve patent satisfaction.
You need to prioritize uniting your team to create a strategic framework, including a governing board, around the basis of providing coordinated, high-quality, efficient, and effective care. From the person who answers the phone to the providers who treat patients, everybody should be on the same page. The incentives need to be for the entire practice, not just the physician.
Additionally, setting goals allows you to fully understand why you are doing certain things and what is important to every stakeholder. This collaboration helps you to identify from an early stage that you have an excellent foundation to build on as you continue with the next steps in the process, with everyone’s needs and goals in mind.
Planning and a collaborative partnership
Once you have created a solid foundation in collaboration with your practice staff, the next step is to create an actionable value-based transition plan so that each person knows the role they play and the tactical elements that will be a part of their new daily workflow. Start with measuring baselines of your practice as it currently is to enable you to measure future success. Then you can educate the providers and staff by breaking out each project component to make implementation easier. Next, work with the rest of the staff: scribes, nurses, medical assistants, and the front desk to analyze and modify or leverage existing provider workflows to achieve broad adoption.
Using the right tools is the key to easy workflow implementation
It’s now time to develop your implementation plan to combine technology and workflow training or partner with Sharecare to implement this for you to ease the adoption of the new systems while fostering a comfortable environment for integrating the new measures into your staff’s daily workflows.
Quick and appropriate referrals to specialists, careful tracking of disease progression, providing clear patient education, and efficient coordination with surgery teams and transplant teams scheduling are crucial. And peer-to-peer comparison data can help providers understand where they had gaps in care and how they stand with patient population outcomes. These are key factors to keep in mind while formulating workflow processes.
At Sharecare, with a value-based/outcome-based model in mind, we start with a standardized process, and then we customize that process with those aspects that are unique to the patient. The patient still gets customized care, but the customization comes from a repeatable framework that allows our users to create efficiency and streamline processes, which results in a better approach to controlling costs. Implementing and automating steps helps reduce the administrative burden, which in the current hiring crisis is more vital than ever, and keeps practices focused on providing exceptional care for patients.
Your Value-based care implementation is done, now you can relax… maybe
Now that you’ve fully engaged your team and implemented the value-based care model in your practice, you’ve opened many possibilities for your practice to continue to refine processes and expand your financial potential. Embrace and explore continuous improvement. Look to expand your geographic footprint. Reach out to self-insured employers and payors beyond Medicare. The framework is set, and you can fully optimize your business and revenue opportunities.
In the end, however, consistency is key. You and your staff have all put a lot of time and effort into integrating the value-based care model into your practice, and it is essential to your success and the long-term sustainability of this approach to stay diligent and committed to your efforts. Revisit your original goals and practice strategy with your staff as you progress to see how you have evolved and where you may need to realign and adjust to get back on track. It’s a process just like any other and may take time to get used to but with communication and ongoing collaboration from everyone, you and your staff can enjoy value-based care success.
In summary:
An effective plan to implement value-based care requires a thoughtful approach. What are your goals, and how do you communicate them? What are your results, and not just financial, not just what you’re required to do, but what are your goals as a united team? And most importantly how do you measure your baselines and success? These are fundamental things to establish. Patient-reported outcomes, patient preferences, return to work, return to play; these things are essential. We need to start documenting these things, and we need to start collecting them. But you don’t have to do it alone. Sharecare’s Value-based Care dashboard offers several features and benefits that include reminders for and documenting care gap closures, provider performance, patient satisfaction and the ability to generate the quality reporting needed to comply with payor organizations.
Sharecare can support your journey in the value-based care world, taking on the administrative burdens and seamlessly guiding you through the processes so that you have an engaged and experienced partner helping to ensure a successful transition and implementation of value-based care.
For more information on all Sharecare’s Value-based Care solutions, click the button below or contact us. We look forward to working with you!