April 26, 2021 - by Parul Saini, Webmedy team
In today's health environment, more and more independent practices are moving towards value-based care. Value-based care is a healthcare model where physicians get paid for the quality of care they provide unlike the traditional model of care where physicians get paid for their services and nothing else.
The value-based care model is one model in which care providers involving hospitals and doctors, are paid based on the care they deliver.
Under the value-based care model, physicians are rewarded for giving patients quality care, by improving patient health outcomes, minimize the consequences and incidence of chronic disease, and live healthier lives in an evidence-based way. Value-based reimbursement is the method of getting paid for finding ways to improve the health of your patients, not providing an expensive list of services to your patients who might struggle to afford them.
The ultimate effect of this care model on healthcare organizations is that they set back and think about what is going to help their patients to reach their health goals more effectively and quickly. This helps the patient gain better results more efficiently. As expensive tests and services are not avoided every time but at least they are no longer the first choice.
As the transition away from traditional, fee-for-service payment models towards value-based reimbursement continues, the implementation of electronic health records (EHRs) is becoming the rule rather than the exception. This type of innovation is a positive and promising step toward the healthcare sector that rewards value instead of volume and treats patients and families as partners in decision making. Compared to the old-fashioned paper and pencil mentality, more streamlined and automated EHRs potentially enhance care quality and reduce the chance of life-threatening medical errors. Hence, big data helps more closely align the healthcare industry with the CMS value-based payment timeline. With the huge amount of data comes greater analytics opportunities that can lead to cost savings. Automation brought about by EHRs and electronic medical records (EMRs) simply saves valuable clinical time and keeps costs down across the industry. As well as communication is improved and so is quality and measures.
As the healthcare industry is moving towards value-based care, it is also still learning how best to make the model work in practice. Hence, private and public providers are expected to innovate rapidly. For practices, that means EHRs built on the cloud will provide not only the ability to scale up or down without incremental investment or administrative overhead, but they will also allow the iteration cycles required to stay ahead of sudden changes in requirements or regulations. Moreover, the new generation of EHRs is avoiding siloes for open, standards-based access to data as well as interoperability, so practices can integrate and interface with other sources as needed.
With different payment models, practices require new functionality to maintain the cost and quality of their populations. New capabilities are therefore being embedded within, or connected to, EHRs. The combination of evidence-based care pathways is particularly important, allowing the EHR to strengthen clinical best practices in the context of a patient encounter, where it can most positively affect outcomes. Further innovations include the incorporation of genomic profiles facilitating precision medicine, and even advanced analytics to report on quality/MIPS measures, metrics, and risk scores in near real-time.
Patient care is the most common word today in the healthcare industry. Study shows that patients who are actively engaged with their physicians in the care journey are likely to have better health outcomes. The effect that high levels of patient engagement have on patient outcomes relates directly to the value-based care model. Providers who use tools to increase patient engagement will see better outcomes and higher levels of reimbursement. Value-based care also increases patient engagement by encouraging providers to focus more on patient care.
In this care model, providers get paid for the care they provide rather than services. This makes sure the provider is staying truly patient-focused rather than payment-focused. This benefits the patient by giving them access to a higher level of care and a provider who has their best interest in mind. Providers are rewarded for supporting patients to improve their health.
With this model of care, providers will find themselves cutting costs and minimizing wasted funds. With the traditional fee-for-service model providers were driven to waste funds on less-than-effective treatments for the sake of payment, costing them more in the end. Value-based care inspires providers to take the most cost-efficient and effective method of care for the patient.
As the healthcare industry continues to grow, healthcare providers started adopting value-based care models. This transition from fee for service to fee for value has been adopted for providing better health outcomes. Adoption of value-based care brings its requirement of the healthcare sector to rethink the tools that will help them get success. When it comes to the EHR, the capabilities of the future will center on the ability of multidisciplinary teams, provided with powerful data and evidence-based pathways, to care for patients holistically across all health issues and care environments. As the patients get better health outcomes, the entire healthcare sector works more efficiently, with fewer hospitalizations and medical emergencies. As a result, resources can instead go into improving the patient experience through improved staffing, new facilities, advanced technology, and other patient-centric investments.