Driving value-based care success by empowering the health plan and provider relationship

Healthcare has embarked on a new era of value-based care success. Achieving value-based care success is dependent on building a strong partnership between health plans and their providers.

When creating these programs, there also has to be strong commitment and buy-in from your provider community. Simultaneously, health plans must ensure that the patient and their care is being kept at the forefront of any value-based care initiatives they’re looking to implement.

This blog explores the importance of value-based care and how health plans can better engage and empower their provider partners in value-based initiatives.

What is value-based care and why is it important?

Value-based care is a model that correlates the amount healthcare providers earn for their services to their patient results. This aims to create accountability and incentives for providers to elevate their care outcomes while also compensating them accordingly. Plus, the prevalence and importance of value-based care success is only increasing.

Establishing trust between providers and health plans

Trust, respect, and control are essential drivers for a successful value-based program. Although both health plans and providers are looking to create and keep patients healthy— conflicting priorities can create confusion, so beginning the relationship with a strong foundation of communication is essential.

Collaboration with providers in developing plans is key to understanding plan requirements and what providers can do to ensure the success of the program. This is a great place to leverage quality and risk data. By teaming up with providers, health plans can create value-based care contracts centered around their patient communities and goals.

It’s important to ask yourself…what motivates these providers? Clinical excellence? Financial incentives or benefits? By understanding this in the beginning, you can create a program around what motivates your providers most. This will help them understand the program from the beginning and support stronger buy-in for the program. It’ll also be essential for health plans to support their providers throughout these value-based care programs because some networks will have more resource support than others.

Creating transparency

Communication is key when it comes to creating a successful value-based care program. Transparent reporting will allow providers to understand where they stand with their results and see where their targets are.

Clear and concise reporting can improve awareness for providers and make their contracts less complicated to understand. Reporting also helps identify patterns and insights to inform providers on how they can tailor their care to impact patients. This type of transparent reporting will allow providers to have an immediate impact and value-based care success.

Navigating complex reporting

Tracking the performance of these programs once they have been implemented can often cause confusion for providers. It is the health plan’s responsibility to ensure their providers are accurately informed of their progress.

Health plans can solve this problem by developing reporting that is simple and easy to follow. Providers want to be able to quickly understand and digest these insights so they can understand what changes need to be made to impact the patient’s health outcome.

Although quick and clear reporting is essential, there also needs to be detailed reports. This can be helpful for providers when they are looking to drill down into specific conditions or patterns. Health plans should provide this quarterly or more frequently, depending on what your provider network prefers.

Personalizing programs for unique populations

Value-based care programs should be tailored for specific populations. Sometimes this means that not all patient populations need a value-based care arrangement. By creating physician advisory boards to weigh in on this, health plans can ensure that the correct populations are being included.

A physician advisory board can also support how value-based care programs are created and help identify what information is needed to meet program goals and keep targets within reach.

By personalizing programs to fit unique population needs, health plans can create a value-based care contract that is tailored to the differing needs of patient and provider communities. When programs are aligned in this way, goals become more understandable and attainable.

Leverage a sophisticated value-based care software

Health plans are increasingly implementing value-based care programs. And while these programs can vary in complexity and depth, there doesn’t have to be an overdue burden on health plans and providers. Cloud-based software such as Converged Provider Enablement can simplify these initiatives and improve member care.

Interested in learning more? Watch our webinar on Empowering the Health Plan and Provider Relationship.

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