Transforming from Fee-For-Service to Value-Based Care: The Cost of Waiting

Are you ready for value-based care?

Everything has a cost, and some costs are greater than others. When it comes to healthcare, can you afford to continue with the fee-for-service model when value-based care is the future?

Commercial payers and the government are leading the shift to value-based healthcare by offering incentives to providers that achieve greater quality outcomes for patient populations. For example, UnitedHealth Group is paying nearly half of its annual reimbursements–nearly $69 billion–to doctors and hospitals via value-based care models that are quickly replacing fee-for-service models throughout the United States (Forbes, October 2018).

UnitedHealth Group indicated to Wall Street that the health plan is well ahead of the pace needed to reach its goal of $75 billion in value-based medical spending by the year 2020. This means that participating physicians and providers will receive financial incentives for better managing the health, quality of care, and cost of their services to the populations they serve.

value-based care

What does my organization need to do differently? How do I prove my providers are hitting their benchmarks? How do we keep track of all the quality measures and patient data from the seemingly endless, disparate EHR systems? How do you know if your organization is ready for the shift to value-based care? These are the most common questions when it comes to earning value-based care incentive payments.

By utilizing Measures Manager™, our cloud-based healthcare software platform from Healthcare Innovation Solutions, Inc., you can dive into your data and assess your readiness to maximize your value-based care reimbursements. Measures Manager™ aggregates information from disparate EHR systems and displays it on a streamlined, easy-to-read dashboard. This dashboard clearly shows how providers are performing against federal and commercial insurance company contract benchmarks, and where gaps in care may exist. MIPS (Merit-Based Incentive Payment System) is one such federal contract that Measures Manager™ tracks, and is a key contract in the shift to the value-based health care model.

We understand the complexity of value-based contracts and how specific quality measures can impact reimbursement rewards. We also understand that using spreadsheets to track measures performance is next to impossible without incurring errors. Let Measures Manager™ take on the burden of crunching data so you’re free to focus on patient care and patient engagement. In one simple dashboard, you can see what actions need to be taken to achieve success on your quaility measures and maximize your reimbursements. In addition, you can see what patients require the most immediate attention, and how each provider is performing on closing measures gaps.

Waiting to proactively transition into a value-based care organization can be costly. Utilizing Measures Manager™ to make the transformation can help you evaluate:

  1. Risk – Can your organization afford a financial gamble based on current quality performance?
  2. Care gaps– Which ones can you close today? Are there any provider trends?
  3. Transformation from fee-for-service - How ready are you?
  4. Outliers - Which providers or measures are out of range and why?
  5. Contract Performance - Will you receive financial rewards based on quality?
  6. Measures Performance - Analyze measures in real time and identify best practices.
  7. Improvement - Gain insights and better manage your performance improvement strategy.

Don’t stumble blindly through your data. Know exactly how ready you are for the value-based care evolution by navigating through your contracts in real-time. Contact us today.

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