All over the world, healthcare systems are struggling with cost recovery despite the hard work of well-intentioned and well-trained healthcare providers. Countless fixes have been tried—error reduction, fraud prevention, practice guidelines enforcement, electronic medical records, etc. Yet none has been able to fulfill their ‘big picture’ promise. As such, healthcare leaders and policy makers needed a fundamentally new way to attack the problem: value-based payment delivery.
According to a new Healthcare Financial Management Association survey, more hospitals and healthcare systems are becoming more capable of functioning in a value-based system, integrating improvements in cost recovery through such practices as screening for Social Security disability eligibility, quick action on claim denials, and assisting patients in getting the right coverage. In a similar survey by Kaufman Hall, it was found that healthcare facilities with a value-based payment program tied to 10 percent or more of their revenue doubled between August 2014 and February 2015.
“I think any doubts about whether we are transitioning to more value-based payment and care delivery models have been dispelled,” said Jim Landman, HFMA’s director of healthcare finance policy. “Now is the time for providers to focus on their capabilities to manage the transition, if they haven’t done so already,” he adds.
Value-Based Payment Systems
The ultimate goal of the value-based payment scheme is to improve long-term patient outcomes without increasing costs, or reducing costs without sacrificing quality of care. The system stresses the importance of moving away from a supply-driven payment system that revolves around what physicians do toward a patient-centered system that focuses on delivering what patients need.
Making the change
Transitioning into a value-based payment system will not be easy, because it requires a wide-encompassing strategy, including restructuring how a practice delivers its services, from organization, to measurement, to reimbursement. The journey will require strong leadership. Additionally, the involvement of a third-party provider who can help roll out the components of a value-based payment system will prove indispensable. The services of companies like DECO Recovery Management are invaluable in this regard, with their proven ability to convert potential bad debt into cash. Their expertise in screening eligibility for Social Security disability for children and adults, helping patients enroll in insurance or Medicaid coverage, and other advocacy-based programs will help healthcare providers focus their efforts on where they matter most—providing high-value care to their patients.
Hospitals, healthcare systems inch toward value-based payments, Fierce Health Finance, June 8, 2015
Survey Shows More Than 50 Percent of Hospital Systems Achieved Return on Investment from Value-Based Payments, Benzinga, Jun. 4, 2015