Key strategies for profitability with new payment models.
Since the Affordable Care Act was signed into law in 2010, CMS has been encouraging physician practices to move from a fee-for-service payment model to one that rewards value. It has been testing models that incentivize clinicians to provide preventive, proactive, and appropriate care that improves patient outcomes and experience and decreases unnecessary healthcare spending. Most recently, it has focused on ensuring health equity across all patient populations.
Many practices experienced the financial benefits of value-based care (VBC) during the height of the COVID-19 pandemic, when they received regular per patient payments from value-based care contracts, despite a significant decline in service volume. If your practice was not amongst them, you may still question whether you can maintain profitability under VBC. You may struggle to understand the terms of contracts, lack the data analytics you need to manage patient populations, or fear you will not be able to make the contracts profitable for your practice.
But value-based care is not an issue of if, but when. Fee-for-service payment is simply not financially sustainable. While your practice may not be ready to make the transition to VBC immediately, you should consider the strategies you’ll need to implement to make these payment models profitable for your practice.
Here are seven strategies to help set your practice up for success when you’re ready to make the switch.
Duane Feger is a health economist who has partnered with public and private healthcare organizations to help them deliver cost effective care, healthier populations, and financial success. He is currently applying his in-depth knowledge of the industry to the design, development and implementation of risk assessment and predictive modeling tools for Acclivity Health Solutions located in Jacksonville, FL. In addition to publishing several white papers in health economics and health analytics, Duane has also presented for John Hopkins at national conferences and leads educational presentations for healthcare providers and administrators.