ACOFP Blog

From a Corporate Council Roundtable Member

Main Street Health

The future of healthcare delivery is rapidly changing, and value-based care is at the forefront of this transformation. Value-based care is a healthcare delivery model that rewards healthcare providers for delivering high-quality care while containing costs and improving patient outcomes. This is a departure from the traditional fee-for-service model, where clinicians are paid for volume instead of quality of care. This blog is a call to action—it’s time to start preparing for value-based care.

Value-based care will continue to grow and become the standard of care in the United States. In October 2021, the Center for Medicare & Medicaid Innovation announced a goal of having every Medicare beneficiary, and most Medicaid beneficiaries, covered by some type of alternative payment model (APM) by 2030. They consider an APM to be any arrangement whereby providers are held accountable for the quality and costs of care, not just paid based on the volume of services they deliver. Providers who are able to implement this model successfully will be better positioned to succeed in an increasingly competitive healthcare environment.

Clinicians can begin to prepare for this transition now by paying attention to three key things:

1. Addressing social determinants of health: In value-based care, clinicians are paid not only to create a care plan but also to ensure patients can follow through to maximize their health outcomes. The most successful value-based care participants have expanded care teams focused on addressing social determinants of health obstacles. Workflows that incorporate solving social barriers are paramount to success in value-based care.
2. Leveraging data at the point of care to close quality gaps: Data across the broader healthcare landscape has become more accessible. Successful value-based care models incorporate data beyond the electronic medical record to help patients reach care goals. For example, having pharmacy data lets clinicians know if patients are adherent to their medications and helps them proactively address any gaps.
3. Building workflows and culture that support value-based care: Reorganizing teams to have the capacity to do this new work and educating teams about the change in the type of work that needs to be done is a crucial exercise in preparing for the future.

By engaging with the right partners or investing in infrastructure, clinics can succeed in providing innovative healthcare services to the next generation of patients.  There are pathways to success that do not require financial risk and offer additional resources for your practices today.

To learn more about these opportunities, please visit https://www.mainstreetruralhealth.com.