A great deal of the conversation around value-based care revolves around alternative payment models.
But collaboration among physicians, teams and facilities within and beyond the hospital walls is no less important.
During a March webinar hosted by Becker's Hospital Review and sponsored by Ingenious Med, Rohit Uppal, MD, chief clinical officer at TeamHealth, and Steven Liu, MD, founder and chief medical officer at Ingenious Med, discussed the role of physician leadership in the adoption of value-based care and how technology platforms can augment physician leaders.
Four takeaways:
1.) Fee-for-service payment models still dominate, but COVID-19 has accelerated the value-based playbook. According to a RAND study cited by the presenters, as many as 80 percent of primary care physicians and 90 percent of specialists still receive fee-for-service compensation tied to volume. Nonetheless, shifts in volume provoked by the pandemic exposed shortcomings of this model.
2.) Physician-led care redesign programs lead to more savings than hospital-led programs. Unlike most value-based programs, which tend to be led administratively by payers or health systems, the Bundled Payments for Care Improvement Advanced model places physicians in the driver's seat. This facilitates better integration because physician leaders have competencies in building continuum of care networks with primary care providers and physicians at acute rehab centers, skilled nursing facilities and home health programs.
"The opportunity to expand beyond the four walls opened up tremendous opportunities for collaboration and system improvements," Dr. Uppal said, describing TeamHealth's experience with BPCI-Advanced. He said it led to improved experience for clinicians, because it allowed them to identify and address barriers and inefficiencies.
"It used to be the physician's pen, but now it's the physician's mouse click that dictates the quality of what happens and what gets ordered," Dr. Liu said.
3.) Engaging and supporting physicians leads to improved patient outcomes. Physician leadership is essential for driving value not only for government and private payers via savings, but also for patients through improved health outcomes. To accomplish this dual goal of greater value for payers and better patient outcomes, organizations need to ensure an environment that provides physicians with aligned incentives, additional support and resources, more data, and meaningful rewards.
4.) Strategies to optimize value-based care performance must simultaneously address multiple elements. To move the needle on value-based care, organizations must focus on:
- Analyzing the highest utilizers of care and identifying addressable commonalities
- Understanding drivers of overutilization and waste along the care spectrum, in the inpatient, post-acute and home settings
- Standardizing clinical care paths and utilization criteria
- Narrowing continuum of care networks
- Partnering around value
- Incentivizing physicians properly
- Leveraging the full potential of telemedicine
"With any value-based care model, the biggest opportunity to reduce waste will almost always be in acute and post-acute settings by ensuring that the intensity of service is matched to the patient's medical needs," Dr. Uppal said.
5.) Technology platforms that operationalize alignment drive success. Platforms such as Ingenious Med's can help health systems overcome EHR inconsistencies between facilities and generate data and analytics at the individual clinician level, as well as allow clinicians to communicate and hand off key clinical information.
"If you're not having these conversations [about value-based care] or you're not hearing about them, you need to make sure that you are because this will be the model of the future," Dr. Liu advised.
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