The value-based care landscape continues to evolve. This is not surprising given the policies and changes that are taking place in our nation’s healthcare delivery system that are driving more payers to align Medicare beneficiaries to value-based payment models. A result of the near constant changes means that providers need to align their practices with multiple payer requirements to create a more efficient and effective healthcare system - and one that is positioned to succeed in today’s environment. Given the individualized and complex requirements of each payer, managing multiple payers can feel like a challenging balancing act that demands careful planning and extensive resources to foster success for payers, providers, and the patients they serve.
With more than a decade of experience in value-based care, we’ve identified three ways providers can create a seamless approach to aligning diverse payer contracts to streamline patient care and improve outcomes.
Standardized tools enable providers to deliver high-quality patient care through the use of reliable, payer-agnostic technologies, workflows, and resources regardless of the payer involved. Payer-agnostic tools and workflows can significantly reduce administrative burden by minimizing the need to adjust to varying payer-specific requirements. Providers are better equipped to scale operations within their current capacity and successfully deliver a continuity of care across all their value-based care programs.
Providers that implement value-based care understand that timely and accurate data is essential for measuring outcomes, adjusting care delivery, and making informed decisions. However, many healthcare organizations still operate in limiting silos, with data locked in separate systems that cannot communicate with each other. To address and correct these challenges, healthcare organizations must invest in technologies that facilitate payer-agnostic data sharing and performance tracking. By disrupting data silos and enabling real-time information exchange, providers can facilitate insights and opportunities to accurately track and improve performance.
Shared risk is a staple of value-based care models where payers and providers share financial responsibility for the quality and cost of patient care. To successfully enter risk arrangements, providers must assess the necessary scale and resources to ensure they can meet performance benchmarks and achieve shared savings. Pooling attributed Medicare beneficiary lives and sharing the risk can help alleviate financial burden, positioning providers to concentrate more on quality improvement initiatives, leading to better patient care outcomes and reduced healthcare spending.
Are you in command of the three S’s?
As value-based care continues to evolve, it will become increasingly imperative that providers prioritize alignment across payer initiatives. By focusing on the three 'S's, payers and providers can work together to achieve more benefits from their value-based care strategy.
Read our recent whitepaper: The future of healthcare delivery is in risk-based payment