How to reap the benefits of value-based reimbursement

It’s been said that the current value-based reimbursement environment is akin to the wild wild West with lots of different models attracting all sorts of pioneers, tempting them to embrace risk and seek greener reimbursement pastures.

Like any good analogy, this one holds a grain of truth: value-based reimbursement, in its various forms, represents a 180-degree shift in how organizations deliver and receive payment for care. Instead of being incentivized to run a lean, low-overhead business that emphasizes seeing as many patients as possible, providers are now being pushed to take on more risk, collaborate across care settings and welcome shared savings opportunities.

 

Further reading: Why are the 2016 presidential candidates ignoring healthcare?

 

Practices looking to reap the benefits of this new path must leave their old fee-for-service life behind and set a course for parts unknown. What this ultimately means for the healthcare industry is still unclear because it is early in the process, and everyone is just trying to figure out how to sort through the wide array of diverse options.

An essential-and underappreciated-part of the journey

As providers commit to pursuing risk-based arrangements, they often focus primarily on restructuring patient care processes to improve quality. Although this is a necessary and valuable strategy, there is another equally-if not more important-step that frequently gets overlooked: the need to accurately and consistently quantify the true costs of care.   

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