Succeeding in Value-Based Care

Healthcare delivery is moving away from the fee-for-service model and toward a value-based platform. The goal of value-based care is to reward healthcare providers for the quality of their care, based on patient outcomes, rather than the number of visits, tests, and procedures they schedule for their patients. Innovative primary care organizations often need guidance in finding a developer-driven value-based platform that can be customized for their specific needs and goals.

The Centers for Medicare & Medicaid Services (CMS) encourage value-based programs that “reward health care providers with incentive payments for the quality of care they give to people ….” Noting that the value-based programs are part of the organization’s larger quality strategy to reform how healthcare is delivered and paid for, CMS also states that the programs support their three-part aim of:

• Better care for individuals
• Better health for populations
• Lower cost.

Innovative primary care organizations will put into place the right technology, including developer-driven electronic health records (EHRs), that will enable them to move forward with providing and being compensated for the quality care that their patients want and deserve.

Elation Health is the only full-stack platform powering primary care. Learn more about the developer-driven value-based platform of choice for primary care visionaries.

These innovative healthcare organizations will also be ahead of the trend, in terms of providing value-based care, as evidenced by a recent Deloitte Survey of US Physicians. In fact, comparisons of the results of these surveys from 2020, 2018, 2016, and 2014 found that physician compensation continues to emphasize volume over value. Specifically, the surveys reveal that:

• In 2020, as in 2018, almost all physicians (97%) relied on FFS and/or salary for their compensation and 36% also drew compensation from value-based payments.
• The proportion of physicians (23%) who receive performance bonuses of more than 5% also hasn’t changed.

Data-driven tools that support physicians also show trends in their availability and usage:

• Only one in two (51%) physicians are aware of the costs of treatments they select.
• Almost half (48%) are comfortable discussing costs with patients.
• Just under half (46%) say they follow clinical pathways adopted at their organization.

The survey results also reveal that there are many untapped opportunities, including the opportunity to find a developer-driven value-based platform that will support the move toward quality over quantity as well as improving the efficiency of that quality care.

Those experts conducting and reviewing the survey results offer the suggestion of three parallel initiatives that will help innovative primary care organizations move more decisively toward value:

• Reorient physician compensation from volume to value and hold physicians accountable for outcomes.
• Build care management capabilities, such as multidisciplinary coordinated care teams, risk stratification, care navigation, and site-of-care optimization.
• Give physicians easy-to-use tools for decision-making and performance improvement.

A critical tool is a developer-driven value-based platform, such as that designed and offered by Elation Health. As described in a recent press release announcing a new financing round for innovative primary care, Elation has become the API-driven, EHR platform of choice for development teams at primary care organizations to accelerate innovative care models without creating technology systems from scratch. The platform currently supports more than a million API calls each day with connections to 300+ technology and healthcare organization collaborators including Dock Health, Hint Health, and Zus Health.