Top 10 Considerations When Moving To A Value Based Medical Practice

 

The Medical System

The Medical System

Physicians and other involved persons are being required to move from the old compensation method to a new value based service. For many this will mean a completely new way of practicing. No longer will client quantity be the basis of payment rather the value of service will be. What do practices need to do to successfully move to this new model? Below are the top 10 items that will need to be addressed.

What is Value?

Currently, there is no definition of value as used in a medical practice. This defining will be an important first step for all practices. Different payer groups may well define value in different ways. The lack of a consistent definition may cause confusion for doctors within a practice.

There is a need for leadership in attempting to define value. Today the first step is compliance with the Healthcare Data and Information Set. However, this compliance is merely a first step.

 

How Should Physicians Report

How Should Physicians Report

How Should Physicians Report on Value?

After the definition of value has been determined the next question of how to report information must be decided. The practice will have to determine how it’s going to report on different measures. It must be a system that can track, monitor and report the new measures. It must also ensure that the appropriate data has been extracted for proper reporting.

How will Value be recorded?

There will need to be a method to document the doctor’s work within the electronic health record. Often this group will have different ways to record this information and to ensure that the appropriate data is extracted. According to Best Practices, this documentation needs to have an identifiable field to record each measure. It should also be easily communicated and reported.

 

New Compliance Standards

New Compliance Standards

Does Your Incentive Program Help with New Compliance Standards?

The incentives or penalties for compliance must be clearly understood by everyone in the group. The incentives must be large enough to encourage doctors to practice in a new way. Penalties on the other must be severe enough that the physician will try to avoid it. For this stage, there are many models that can be used or groups may develop their own.

The Importance of Education in Value Based Practices

The education of practicing doctors in the new measures is vital. Perhaps it’s the most important aspect of all. This knowledge or lack of it could save or break a practice. Physicians may feel overwhelmed as they will be asked to change how they practice as well as how they document. Periodic educational sessions will be needed to ensure everyone understands what is expected of them.

 

Uncertainty

Uncertainty

Living in an Unclear World – The Burden of a Value Based Practice.

During the early stage of this transition, doctors may feel they have been asked to carry an extra burden. They will be required to meet the additional steps to a value-based system while still working in a fee-for-service practice. Physicians will be required to spend a longer time with clients or in documentation duties.

The greatest burden will be placed on primary care physicians. It will be essential to the transition that they are not asked to make so many changes at once. If this transition is not done slowly and with a plan, the doctor may feel so overwhelmed that they leave the practice.

 

total compensation

total compensation

How Value-based Practices Affect Total Compensation?

Doctors, as well as other key persons, will need to understand how the incentives or penalties that are used will affect their total compensation. To start it needs to be determined at what % do the incentives and penalties affect payment. More importantly does the employment contract need to be rewritten in light of these penalties or incentives? The area of compensation may be a little tricky at first but given time and support it will most likely be accepted.

The Timeliness of Reporting Deficiencies to Physicians

It should be stressed that the timeliness of reporting is vital in all types of practices. Those who oversee the quality of training must allow doctors a reasonable chance to correct the deficiencies of their practice. This reporting will allow them time to make changes before penalties are assigned. Reporting defects is a large part of making sure that physicians understand what they need to do and how to do it during the transition.

 

Payer Partners

Payer Partners

Payer Partners Must Be Considered During the Transitioning

Different Payer partners may have different needs when it comes to measuring various values. They should be consulted early if possible. It will be essential to find out their needs. They should express their needs clearly in order to support the transition. Groups must be open and honest with payers as they attempt to establish programs to meet all of the payers needs without having several different ones.

Value based practice in one of the largest changes that have occurred in the last several decades. It needs not be difficult if everyone works together with a common goal.

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