Value-Based care: It really is coming, and virtual care is part of the equation

We've all seen the news: Value-based care is coming, it's inevitable, it's here. But many health systems have yet to see major impacts from value-based reimbursement models such as accountable care organizations (ACOs), bundled payments, or patient-centered medical homes.

Consequently, it's easy to think that the hype around value-based care is just that: hype. We need to think again.

It's not Hype
Value-based care really is coming, and soon health systems won't be able to escape it. In early 2015, the Healthcare Transformation Task Force announced that 20 major health systems and insurers committed to moving 75% of contracts into value-based arrangements by 2020. The U.S. Department of Health and Human Services (HHS) expects that by the end of 2018 half of Medicare payments will go to alternative payment models, such as ACOs and healthcare organizations that accept bundled payments. And, a 2014 study by Avility revealed that more than 60% of providers expected value-based payment models to become dominant going forward.

What is Value-Based Care?
Traditionally, reimbursement has been volume-based. Under this model, providers are paid based on the number and type of visit. At its core, value-based healthcare encompasses a series of alternative payment models designed to support the triple aim of better patient access, lower healthcare costs and improved clinical quality. These models include accountable care organizations (ACO), patient-centered medical homes (PCMH), pay-for-performance and bundled payments. Under each of these payment models, health systems and providers are rewarded when they deliver quality care using fewer resources.

So, how can health systems who still operate in a volume rather than value-based reimbursement environment get ready for the shift? Look to virtual care.

The Impact of Virtual Care in a Value-Based Environment
Health systems looking toward the transition from volume to value-based care can benefit from launching a patient-provider virtual care solution. Virtual care can help health systems reduce costs by transitioning patients to a lower-cost access point, minimizing office visits, urgent care encounters and even trips to the emergency room. Health systems can also see the benefit of enhanced patient health outcomes, including stronger patient engagement and population health management.

Lowering Cost of Care
The online access point in a virtual care service offers health systems and patients a lower-cost diagnosis and treatment option. Using a "store-and-forward" solution like the Zipnosis online adaptive interview enables providers to diagnose and treat common acute conditions quickly and efficiently. Provider time per visit on the Zipnosis platform is typically around 2 minutes to diagnose and treat, compared with 15-20 minutes for an office visit.

Improving Patient Outcomes
Patient engagement isn't just an industry buzzword; according to, people who are actively involved in their health and healthcare tend to have better outcomes. Offering a convenient, online access point can help increase engagement by making healthcare fit into patients' lives. Additionally, patients may seek treatment through a virtual access point when they might otherwise decide against seeking care - that could be the difference between a routine UTI, which left untreated, could lead to a serious kidney infection.

Health systems and patients can also use virtual care as a population health tool. Online health assessments, for example, can help identify patients who are at risk for chronic conditions before those conditions become problematic. And, using an online access point for follow-up visits can help keep patients engaged in their care by making it quick and easy to provide their physicians with health information in between office visits.

Act Now to be Prepared for the Future
In the 2016 HIMSS Cost Accounting Survey only 3% of respondents indicated their health systems were highly prepared to to adopt value-based care reimbursement and leave behind volume-based, fee-for-service payment models. While a full transition to value-based care may seem distant, many leading health systems are taking steps to prepare for the inevitable transition to value-based reimbursement.

Health systems who launch virtual care as a means for providing cost-effective care in a value-based environment will have the time to:
• Work through change management and build clinician buy-in across their organization
• Develop and implement a strategy that ties together online care delivery across departments and specialties
• Monitor and enhance their virtual care service to ensure it meets the needs of both patients and the health system
• Fully integrate virtual care with internal IT systems to promote a seamless patient and provider experience

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