Value-Based Care: Building a Strategy for Improved Outcomes and Lower Costs

It’s no secret that the post-acute healthcare industry is working diligently to improve patient outcomes while reducing the costs it takes to achieve them. The current payment environment is shifting toward the value-based care approach and organizations across the country are carefully navigating the path to implement the right processes and technology to thrive in the new setting where provider payments are based on the quality of the outcomes.

There is a lack of incentive for ensuring long-term successful outcomes under a traditional fee-for-service where providers are reimbursed for the quantity of the services provided, versus the quality of care they provide. The shift to a value-based care model drives to a need for care coordination strategies and technology. Care coordination can improve outcomes for an individual when providers collaborate to ensure the right care at the right time occurs. This supports the goal of achieving optimal wellness for individuals at a lower cost for payers and providers.

Enter Value-based Care

With the shift from episodic care to continuous, whole-person care, the underlying principle is simple—improving overall population health through better quality and safety for patients at a reasonable cost for organizations. Under this model, providers are incentivized to proactively manage a patient’s care successfully across the care continuum. Reimbursements are tied to keeping people healthy and improving the health of individuals who have chronic or comorbid conditions in a cost-effective way. In a value-based care environment, organizations must work together to coordinate care effectively and assure the right care transitions occur.

Implementing technology to drive comprehensive care plans requires the right electronic health record (EHR) which should have the capacity to securely and seamlessly connect and communicate with providers across the healthcare spectrum, allowing for smooth care coordination and effective transitions of care. To reinforce this, your EHR should support sending and receiving of referrals and allow seamless, secure exchange and aggregation of patient data. This helps drive a longitudinal patient record.

Once the technology pieces are connected, long-term care organizations can find themselves in a position to have tremendous, positive impact and influence on the fiscal success of not only their own organizations, but also partner organizations.

Strength in Numbers

As your organization moves to a value-based care model, an EHR alone isn’t enough. Connectivity with healthcare partners, such as hospitals or health systems, is essential to establishing a presence on the value-based care playing field. Acute, post-acute and behavioral healthcare providers are banding together to access the full benefits integrated care. Potential partners are looking for LTC connections who can provide more than an EHR with proven data exchange and analytic capabilities that allows them to continuously report on positive care outcomes. As part of these integrated care communities, care providers will be asked to assume risk and be accountable for outcomes.

These types of relationships are forming each and every day. As opportunities to partner with an established and successful network begin to taper, your organization will need to ensure its value and appeal to potential partners. A thorough review of your organization’s operations and technology is essential to find out if you’re ready to join an integrated care network or if adjustments need to be made to become a desirable post-acute partner.

The key to forming the right partnerships is being proactive. Understand the role your organization plays in the bigger picture and begin establishing networks in your region with those who are committed to value-based care and managing their patient population’s health.

Most Important Question

There’s no doubt that the shift to value-based care is happening now. At a time when lowering costs, improving outcomes and increasing patient satisfaction are more important than ever. Organizations need to begin planning and executing the right moves to ensure they can remain a competitive player in the post-acute realm. Savvy post-acute providers are adopting technology and making strategic partnerships now so they aren’t left behind.

Where does your organization stand? Ask yourself, “What is my organization’s risk tolerance? Do we have the tools in place to appropriately manage it?” Join our free webinar titled The Journey to Integrated Whole Person Care Oct. 26, 2017 where we will explore the best ways to leverage technology, strategies and relationships that your organization needs to implement to succeed in becoming a preferred post-acute care provider in your area.

Topics: Articles , Executive Leadership