How Sound Physicians uses value-based care to improve quality and lower costs

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There's ample opportunity to increase quality, improve the patient experience, and drive margin using value-based care, but organizations have to implement and scale the strategy properly to be successful.  

During Becker's CEO and CFO Virtual Event on Nov. 11, leaders from Sound Physicians, a national physician practice, hosted a featured session to discuss their organization's strategy to provide value-based care while improving care quality and creating a return on investment. 

The presenters were:

  • John Birkmeyer, MD, Chief Clinical Officer at Sound Physicians
  • Robert Bessler, MD, CEO and Founder of Sound Physicians

Sound Physicians' vision is to improve quality and reduce the cost of care for patients in the communities they serve. Through a culture of continuous learning and improvement, Sound Physicians has become the largest episode initiator in CMS' Bundled Payment for Care Improvement initiative, seeing over 70,000 episodes in the program annually.  

Below are four key points about Sound Physicians' strategy: 

Why value-based care?

In 2014, Sound Physicians pivoted to value-based care, improving quality and driving a lower cost of care throughout the acute 90-day episode, Dr. Bessler said. Sound Physicians developed a consistent, clinical model, creating improved patient outcomes and a positive return on investment by implementing value-based care on a national scale. This care model centers on empowering clinicians to engage patients in goals of care conversations and align to their needs and wishes.  

The most important levers of a value-based care model

To cut both readmissions and post-acute care spend, Dr. Birkmeyer named four of the most important clinical levers for Sound Physicians' value-based care model. The most significant lever is the physician ownership of total cost of care, which includes consistent measuring and education, along with metric-driven financial incentives. 

Another key lever is enabling technology, Dr. Birkmeyer said. Sound Physicians uses a charge capture and analytics platform to flag high-risk patients for potential adverse outcomes. For those patients, physicians are queried with regards to different aspects of care and specific questions to ask patients so they can ensure the best possible outcome. The analytics platform can be leveraged to show physician leaders and frontline clinicians how they're doing in comparison to peers, as well as what clinical subsets of patients may have care opportunities or gaps. The organization also uses telemedicine for value-based care, extending the reach of hospitalists into skilled nursing facilities via virtual visits. The telemedicine effort has been a scalable and inexpensive approach to mitigating clinical escalations and keeping patients in the SNF when it's safe to do so, according to Dr. Birkmeyer.

The other key leavers are a consistent clinical care model and partnerships for post-acute care plans.

Results 

Gross savings rate is the most direct way to summarize improvement over time, according to Dr. Birkmeyer. Over the first three full years of the BPCI program, Sound Physicians' GSR increased from 2 to 3 percent to nearly 10 percent. Dr. Birkmeyer said the organization's biggest improvement is physician adherence to advanced care planning. In addition to the gross savings rate, Sound has seen the following clinical results: 

  • 12x increase in advance care planning 
  • 15 percent decrease in skilled nursing facility utilization
  • 4.6 percent reduction in skilled nursing facility length of stay
  • 39 percent reduction in long-term acute care utilization

One big thing 

"It sounds obvious, but value-based care is about doing what's best for the patient," Dr. Bessler said. "It's not about saving money; it's about better outcomes for patients."  

To learn more about Sound Physicians, click here. To view the whole presentation, click here

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