7 Reasons to Join a Payer's Value-Based Payment Plan

February 27, 2017

Value-based care is a scary prospect for many physicians. Here are seven reasons why they shouldn't be afraid.

Value-based payment arrangements are confusing and concerning to many physicians. However, whether you're ready or not, value is coming and delaying the inevitable is probably not the best strategy. In fact, getting on board now with a payer's value-based payment arrangement might be the smartest move a practice can make, experts say.

Here are a few reasons to jump in now rather than later:

Get Ahead of the Curve

Because many payers plan to transition away from fee-for-service, it makes sense to be an early adopter of value-based payment initiatives. Mott Blair, a family physician in Wallace, N.C., says his practice already has a health coach and can identify high-risk patients so they can be more pro-active about their care. When everyone else is scrambling to get their systems lined up with value-based payment, practices like Mott's will already reap the benefits.

"It may cost more on the front end, but in the long run it will make the adjustment much easier," he says.

Get Paid for Proactive Care

Most practices spend far more time on patient care than they get paid for. From returning a patient's call about medication side-effects to following up on missed appointments, practices do a lot of work that doesn't fit in a fee-for-service model.  In a value-based payment arrangement, they will be rewarded for making these things a part of their regular routine.

The way Michael L. Munger, a family physician in Overland Park, Kansas and President-elect of the American Academy of Family Physicians, sees it, "A value-based payment arrangement supports the ability to be proactive in your patients' care."

Get More Referrals

Getting involved early can give smaller practices an edge when it comes to referrals, in particular specialists. "If a local hospital starts setting up a system [of providers for coordinated care], you don't want to be left out," says Elizabeth Woodcock, president of Woodcock and Associates, an Atlanta-based physician practice consulting firm. "The market is a web of relationships, and you need to be in the game in your market if you want to get referrals."

Do the Work You Were Trained to Do

In recent years, many doctors have begun to feel like they practice office management more than they practice medicine. Even though it may seem like a physician is stepping into just another regulatory headache, value-based payment actually puts the emphasis back on patient care, experts say-even though it may not seem like it at first.

“It’s kind of like the question of whether to build [electronic] cars first or charging stations first,” says Blair. “Focusing on the outcome helps give better patient care, but first you have get set up to do it.”

Get on Top of MACRA

“There’s a little thing called MACRA,” says Munger. “And it’s not going anywhere.”

Getting in on a payer’s value-based payment system might seem like a risky move now, but “it will give you a head start on MACRA,” says Blair, giving you a leg up on the changes you need to make to meet the new guidelines.

“You’ll have to have that patient data sooner or later,” Blair points out. You might as well start tracking it now.

Understand Patients Better

To be successful in a value-based payment system, practices have to understand their patient base. This is both a challenge and a benefit to value-based care, experts say.

"I have to know my panel," says Blair, "who they are, what their problems are. You have to have that data."

And having that data makes giving good quality care much easier. The better physicians understand their patients, the better they can care for them.

It's the Right Thing to Do

When it comes down to it, the reason healthcare stakeholders are advocating for a value-based payment system is because it will ideally lead to better patient care by paying physicians for keeping their patients healthy, rather than paying them to see patients. Like reducing blood pressure with dietary changes, the process may take a little time.

"You can call it 'investing in the future,'" said Woodcock, "but when it comes down to it, we're really just doing it because it's the right thing to do."