As a part of this blog series, we’ve discussed what the transition from volume-to-value based care looks like for the Provider as well as the Physician. Although, it could be argued that no segment of the healthcare industry has as much influence in ushering in this new care model as Payors do. What does this mean for the Payor? How will they be impacted and what can they do to ensure a smooth transition to this new model?
What does Value-Based Care mean to Payors?
Volume-based care (fee-for-service) has caused great challenges in healthcare throughout the past decades. It created an unhealthy environment of over-treatment where incentives sometimes aligned with conducting more procedures and doing more for the patient which did not always translate to doing better for the patient. This system drove up costs for the patient without necessarily improving the patient’s well-being.
Value-Based Care is in the process of reshaping the entire healthcare landscape and physicians are not immune to this change. This transition is restructuring patient care and reimbursement, putting more emphasis on cost reduction and patient outcomes.
What does Value-Based Care mean to Physicians?
Many physicians are unsure about the transition to Value-Based Care. It is reported that 78 percent of physicians are concerned that value-based care models will overlook quality improvements that do not fall under specific performance goals, and 62 percent of physicians are concerned that performance goals will be unreasonable in Value-Based Care Models.
Providers are in a difficult position in today’s healthcare climate. They are faced with the challenge of delivering quality patient care while still managing their costs in an effective way. Hospital leadership has distinct goals of financial stability, positive relationships with physicians, and smart investments in innovative information systems that ideally will come together to create a successful healthcare operation.
With the current volume-based care model, providers are rewarded for the number of procedures and services performed as opposed to the patient’s outcome from the services that were provided. Many agree that the shift to value-based care is going to be better for the patient, but how can this shift positively impact the provider? And how can the provider be better prepared for the changes that are to come?
The Society for Design and Process Science (SDPS) will be hosting their 21st International Conference in Orlando, FL from December 4 – 6, 2016 at Rosen College of Hospitality Management at the University of Central Florida. Vincari’s Chief Technology Officer, Dr. Maqbool Patel, will be a featured Keynote speaker and discuss “Developing Software for Healthcare – A CTO’s Perspective.”
SDPS has a vision to be a catalyst for change, enabling the discovery of new approaches that lead to alternative solutions for the increasingly complex problems that face civilization. The 21st International Conference will host industrialists and academicians interested in transformative transdisciplinary research from five continents. It will explore the vast possibilities of highly complex systems that emerge from interconnected disciplinary foci of today’s science, medicine, and technology.
There is a dramatic transition of power occurring in the United States.
That is, the Healthcare industry’s transition from volume-based care to value-based care. You didn’t think we were talking about The Election, did you?
The shift from pay for volume (fee-for-service) to pay for value (value-based care) is here. This can be an intimidating and confusing topic and many are wondering why this change is occurring. The truth is that the current volume based model has caused pain to many segments of the healthcare industry. So how can a value based model help alleviate this pain? Let’s take a look at the 4 P’s: Providers, Physicians, Payors, and Patients.