Like it or not, we are living in a value-based care (VBC) world.

While there are some hurdles to overcome to be successful, the benefits of improved revenue and better patient outcomes far outweigh the effort. As you’ll see, there are ways to achieve your VBC goals while minimizing the required time and resources for PCPs and staff.

  1. Data, data, data : Everything starts with data. You need it to get a complete picture of the patient’s health, identify gaps in patient care and improve medication adherence. Whether you work with an in-house data team or with a vendor, having rich, well-documented data on your patients is key to increasing reimbursements in VBC arrangements and ensuring patients are getting the best care possible.
  2. Risk and quality : Success in VBC depends on accurately assessing the clinical needs of your population and reporting these needs so that your payments will be sufficient to deliver appropriate care. The challenge is that risk adjustment and quality reporting is labor intensive and is predicated on a complex set of rules, which frequently becomes a stumbling block for practices.Because of the complex payment methodology associated with risk adjustment, appropriate coding specificity is needed to accurately report chronic conditions. Without this specificity, plans and PCPs may end up with artificially low patient risk scores, resulting in insufficient funds to deliver adequate levels of care.

    Similarly, PCPs must adhere to the reporting standards for quality gap closures. Deviation can result in sub-standard outcomes. For practices that lack specialized coding and quality technology, as well as properly trained staff, keeping up with these activities is a significant challenge.

To read full download the whitepaper:

Five challenges to VBC success— and how to overcome them

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