The article from Medical Economics discusses best practices for physician practices transitioning to value-based care (VBC). It emphasizes starting with low-risk agreements to ease into VBC. Practices can then use data to optimize performance for more comprehensive contracts. Key strategies include reviewing fee-for-service performance with HEDIS measures. Additionally, they recommend conducting independent assessments of practice performance. Practices should focus on team-based care where all staff contribute to patient care management. The goal is to thrive in both fee-for-service and value-based systems.
Key Challenges:
- Engage Patients Actively: Encouraging patient participation in their own care plans, including prevention and follow-up care, is a crucial part. In value-based care models, this approach improves patient outcomes.
- Data Management: Effectively using data for performance measurement and optimization can be difficult. Practices need the right infrastructure and tools to track and analyze quality measures.
- Risk Management: Practices face challenges in managing financial risk while transitioning to value-based care agreements. This is especially difficult with complex or high-risk patient populations.
How We Can Help:
- ENSURECM©: This solution places a strong emphasis on improving patient population health outcomes through automated notifications delivered via email or SMS. These notifications keep providers informed about critical clinical events, such as hospital admissions, the submission of new diagnosis codes by specialists, or the availability of generic alternatives for brand-name prescriptions. The platform enables patient engagement monitoring by tracking patient engagement through EMR care events using FHIR connectivity. Therefore, it encourages patients to actively participate in their care plans. It also supports workflow management and omni-channel communication to help multi-disciplinary care teams coordinate effectively. This is especially important for complex or high-risk patient populations.
- ENSUREQUAL©: The Quality Program Management tool, has the ability to calculate and track performance. It also monitors progress toward achieving 100% standards for each measure and supports a high total quality score (TQS).
- ENSURESTARS©: This solution provides a full Medicare Advantage STARS dashboard,. It includes a Star measure performance trending, Star rating optimizer and star rating scenario planning for Medicare Advantage health plans.
- ENSURERS©: The risk adjustment management module helps with the identification of suspected clinical conditions. It allows users to track documented and undocumented clinical conditions for these suspects. Additionally, the module can re-document clinical conditions from prior periods for existing patients.
Incorporating Ensure Data Solutions as the data analytics tool into healthcare practices can effectively address the challenges of transitioning to value-based care. As a result, providers are able to optimize risk management, improve performance, enhance patient engagement, and streamline resource allocation. Ultimately, this drives better outcomes, greater efficiency, and more sustainable financial success.
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Source:
https://www.medicaleconomics.com/view/from-challenge-to-change-best-practices-for-value-based-care