The Truth About Value Based Care

Benjamin "The Clark Side" Dickinson
May 5, 2022

Value-based care is a delivery model for healthcare that has recently been implemented by Medicare and Medicaid. It reimburses providers for good, quality care. This change in billing strategy is revolutionary, a change from the fee-for-service model. In that old model, quantity was rewarded. It was wasteful and did not truly keep the patient’s needs in mind. Put simply, the value-based care models revolve around results. Results such as healthier patients, fewer readmissions, and robust preventative care. But what do you really get out of these newer models?

How will the value based care model affect your practice?

  1. The patient saves money.
    If a patient feels that the care they are receiving is not beneficial and therefore may not be necessary in the future, that’s money lost for you. By providing high quality care from the start, patients get better sooner. This fosters trust, so they can afford a future visit and they will want to choose you when possible.
  2. Your efficiency improves.
    By following value-based care models, you’ll focus on providing quality care in each and every appointment. That provisioning frees up wasted time by treating chronic problems less and the cause of those problems more. This allows you to see more patients in the day as a result, which means more money in your pocket.
  3. Cost of medical supplies will decrease.
    Once value-based care is established, medical suppliers will notice the change in business. Healthier
    people don’t need medicactions or treatment as often, or even at all. To adapt, they will have to sell their products for a fairer price. This means you yourself will not pay as much for supplies your practice needs to have on hand.
  4. The world gets healthy.
    With value-based care, less time is wasted on being sick, treating the sick, and being out of work.
    Instead, people are healthier longer, they prevent their many illnesses, and keep working. Much of this money eventually leads back to you, when someone does finally get sick.

How does Value-based Care Change Delivery?

Value-based care calls for teamwork. To ensure you make the right call, you share important patient
information with other doctors (within HIPAA guidelines). With many people working together, you can ensure many angles of care are covered. This is called a Patient Centered Medical Home (PCMH). It’s the team you direct as you diagnos a patient. One of the main goals of Patient Centered Medical Homes is to reduce redundant procedures and their costs.

Accountable Care Organizations (ACO) are a similar alternative to Patient Cenderted Medical Homes.
In Accountable Care Organizations, the members of the team share the risks and rewards of their
performance. This removes the incentive for uneccessary testing, since the current models pay doctors for all the tests they perform, necessary or not.

Bundled Payment is the last model available. In this model, payment and reimbursement are on an
“episodic” basis. Each case that comes up is paid by and reimbursed to the hospital and the involved
physicians. This means there is risk involved, but a sizeable reward if you succeed.

How does Value-based Care Change Spending?

Value-based care rewards your quality care with reimbursements on what you’ve spent. The less you spend and the better your care, the more you get reimbursed. This is based on a number of criteria, however: reducing accidents, using evidence-based practices for optimal results, improving procedures for patient experiences, and staying transparent with patients. This is only a start and these critera will be refined as time goes on.

Conclusion for Value-based Care?

Value-based care can ensure therapists and doctors are effectively caring for their patients. It can save money and revolutionize lives. It does, however, carry a steep burden. Adjusting your billing practices and RCM may be a long term effect of changing the process of bililng both insurance and clients. Schedule a demo with PatientStudio today to see the features that are already in place to help you adjust your current systems.


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