Across the past several years, health systems have invested in early-stage value-based care capabilities.
Across the country, organizations have committed substantial time and resources to assemble and deploy value-based care assets, typically with the aim of gaining market share through risk contracts and improving outcomes through aligned incentives.
But many organizations have seen little material benefit to date. Market share gains have been underwhelming, and securing enough lives at risk to meaningfully change outcomes still seems like a distant goal for many.
In fact, with most of us still living in a largely fee-for-service (FFS) world, these assets may seem ahead of their time. But thinking about our investments too narrowly means we are missing important opportunities. Why not use the accumulated assets to deliver value to patients, providers and the system in the present—and, in the process, gain share and cut costs today?
Grab Early Wins in Costs
Maybe the clearest example is the opportunity to reduce inpatient costs by engaging select physician specialty practices or Clinically Integrated Networks (CINs) and Hospital Efficiency Improvement Programs (HEIPs). Existing quality improvement programs typically target long-term population health goals and so focus more on primary care physicians and the measures they impact.
When it comes to integrating specialists though, they are often far less robust. Yet especially in FFS, specialists hold the keys to driving quality improvements in high-impact areas that reduce the cost of care and yield meaningful ROI.
Health systems should identify and partner with physician leaders in their network to establish key value-driven performance metrics in these areas. The work should also include building out the supporting protocols, policies—and sustainable incentive models—to change physician behavior.
Engage Physician on Measurable, High-Impact Initiatives
As an example, total joint and spine procedures are commonly low-hanging fruit and an opportunity to align more closely with orthopedics and neurosurgery. Optimizing performance in the cath lab requires active engagement from interventional cardiology, electrophysiology (EPs), and key vascular surgeons. And facilitating collaboration between hospitalists and consulting physicians is an important means to close care gaps and bottlenecks, allowing patients to move more efficiently through the care continuum.
HEIPs have proven a valuable tool in moving beyond the single-specialty co-management agreements of yesterday to drive meaningful and longer-lasting improvements.
Compete on Value through Accessibility
Value-based care capabilities can provide more immediate benefit than reducing costs while protecting care quality. Health systems need to think creatively about how to target value-based care assets toward attracting and retaining patients in order to capture market share today.
Health system executives can begin by asking themselves:
• Can patients easily access our providers, services, and facilities? So, for example, does the network of affiliated physicians offer a portfolio of distinct primary care models that appeal to different patient segments?
• Do the physical locations offer convenient access for patients across the target geography?
• Are the care sites complemented by technology-enabled conveniences including online scheduling and, more importantly, virtual visits?
• Are patients able to navigate their care across multiple sites and providers?
• Do patients have a consistently high service experience that engenders their loyalty?
• Do they benefit from—and perceive—high-quality care?
Instead of getting stuck in a holding pattern, health systems should take this moment to look with fresh eyes at their value-based care strategy. Risk may seem to be coming in fits and starts, but with thoughtful, targeted enhancements, your value-based care strategy can drive value today and serve as much-needed practice for the future.