Adapting to Value-Based Care as a
Small Practice

Value-Based Care

With the transition to value-based care, independent practices are struggling to keep up with the change and avoid being absorbed by hospitals and larger networks. Physicians Practice cites “declining reimbursement rates, intense regulations, greater administrative demands, increasing compliance costs and changing payment models” as the primary stressors these small practices have difficulty overcoming. 

Despite this ongoing trend, independent practices can incorporate strategies designed to ensure patient needs are met and incentives are maximized. By ensuring your practice encourages a healthy work-life balance and patient-centered care, you can be successful and avoid unfortunate hospital acquisitions.

Putting the Patient First

Effective value-based care is centered on the idea of providing preventative care for patients and recognizing needs on an ongoing basis. To do so, your practice needs to understand the patient perspective and center care around those direct needs.

The patient-centered experience extends beyond the exam room. Nurses, front office staff, billing personnel and other employees need to incorporate this model into their daily interactions with patients. By streamlining processes in all areas, you can ensure everyone in your practice is on the same page.

Understanding Your Role

The value-based care model must be incorporated into daily practice routines because industry reimbursement systems are gravitating toward and aligning with population health metrics.

The Merit-Based Incentive Payment System, or MIPS, incentivizes practices to recognize and close care gaps, and provides reimbursement for up to 20 minutes per month for any healthcare provider to engage in chronic care management with high risk patients. Other payers are starting to adopt this approach as well.

As a practice, it’s crucial you understand how the system works, how to report data and how to maximize incentives.

A Consultation

Utilize Technology

Efficient electronic tools can help make the transition to value-based care simpler for you and your staff. Population health tools are designed to work with your EHR and analyze your practice as a whole. The tool also allows you to track Clinical Quality Measures, or CQMs, which are tools CMS utilizes to measure and track the quality of health care services provided by eligible professionals in order to ensure that the system is delivering efficient, patient-centered care. Population health also monitors chronic care patients, which allows a provider to walk patients through points based on their individual care plan, resulting in a higher level of care. This combination of tools ensures patient-centered care and rewards practices following these systems.

Engage Patients

Finally, it does no good to highlight patients in need of care if there is no way to motivate them to take action. The problem, however, comes in if this task requires a substantial amount of provider or administrative staff time. Instead of individual manual calls to each patient, the tool should be able to perform a mass outreach by sending an automated telephone call or text message to the designated patients reminding them to take and action or come in for an appointment.

To learn more about creating a patient-centered practice and providing value-based care, read our Knowledge Drop.