The terrain of healthcare is transitioning from a Fee-for-Service (FFS) blueprint to a Value-Based Payment System (VBPS). A combination of factors, such as escalating healthcare expenditures, the urgency to enhance patient outcomes, and a growing preference for value over volume, is propelling this change.
The FFS model stimulates providers to deliver more services, irrespective of their necessity, leading to surplus tests, procedures, and medications, and ultimately escalating costs. Conversely, VBPS emphasizes the provision of high-quality, cost-efficient care, where providers’ remuneration is based on the quality, rather than the quantity, of services.
The shift from FFS to VBPS isn’t a cakewalk. It demands considerable adjustments in healthcare providers’ modus operandi. Here, integrated healthcare services can be instrumental in aiding this transition.
Integrated healthcare services offer a comprehensive array of solutions that aid providers in refining their operations, curtailing costs, and elevating patient outcomes. These solutions encompass:
- Administrative assistance services, like prior authorization, patient registration, and fax management.
- Patient interaction services, such as proactive follow-up and contact center services.
- Operational efficacy services, including chart preparation, paper chart transcription, medical scribing and data abstraction.
- Financial management services, like patient claims reconciliation, patient co-payment reconciliation, and medical coding.
- Care synchronization services, such as referral integrity and live care gaps reminder.
Collectively, these integrated services can facilitate providers in hastening the transition to VBPS. They can alleviate administrative burdens, streamline operations, augment financial management, and improve patient outcomes.
Alongside these specific services, integrated healthcare providers can offer several additional benefits to providers making the switch to VBPS. These benefits could include:
- Expertise in VBPS: Integrated healthcare providers possess extensive know-how in VBPS. They can assist providers in comprehending the VBPS model, devising a VBPS strategy, and executing VBPS initiatives.
- Access to resources: Integrated healthcare providers have a wealth of resources at their disposal, including data, tools, and expertise. These resources can aid providers in refining their operations, reducing costs, and enhancing patient outcomes.
- Support: Integrated healthcare providers can offer support to providers shifting to VBPS, such as educational resources, training, and coaching.
The transition to VBPS is a convoluted and demanding journey. However, integrated healthcare services can simplify this process and increase the likelihood of success. By offering a broad spectrum of solutions and support, integrated healthcare providers can assist providers in expediting the transition to VBPS and achieving the objectives of VBPS.
-  B. Betts, “Value-Based Payments by 2025: Inside HHS’s Ambitious Goal,” Healthcare Innovation, 2020.
-  R. Mechanic, “When New Medicare Payment Systems Collide,” New England Journal of Medicine, 2016.
-  J. D. Reschovsky et al., “Containing the High Cost of Free Care,” Health Affairs, 2022.
-  M. McClellan, “Moving from Volume-Driven Medicine Towards Accountable Care,” The American Journal of Managed Care, 2011.
-  Value-Based Care: What It Is, and Why It’s Needed” by the Commonwealth Fund (February 2023).
-  Value-Based Payment As A Tool To Address Excess US Health Spending” by Health Affairs (October 2022).
-  Investing in the new era of value-based care” by McKinsey (February 2023).
-  Value-Based Care News” by RevCycleIntelligence (May 2023).