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Tips on introducing value-based quality care to the day-to-day operations of your organization

As healthcare continues to embrace value-based quality care, it’s increasingly important for organization leaders to be on-trend.

Those who can quickly implement this way of thinking and operating will see an increase in patient engagement as a result of higher quality care. Those who struggle to embrace value-based care will fall behind as consumers turn to other, more attentive providers who can offer better results.

Here are three tips to help your organization succeed in its transition to providing value-based care as opposed to fee-for-service treatment.

1. Streamline front-end operations and payment processes

One of the biggest areas for opportunity with a value-based care model is front-of-house operations. Patients don’t like having to wait for their provider if they show up on time for their appointment. When being admitted into a hospital or skilled nursing facility, it’s not ideal to fill out piles of paperwork, either.

This means you must streamline your front-end operations, no matter the kind of organization you run. Make it easier for patients to provide their eligibility information, and help your staff verify eligibility by investing in the right software.

Advanced verification and claims management tools like Eligibility Workflow can significantly speed up the entire billing process. They’ll provide your team with all the information they need to share with patients. To embrace value-based care even more, ask your team to clearly explain patient eligibility.

Patients who have a better understanding of their coverage and payment responsibilities will show higher levels of engagement. They’re also more likely to pay what they owe on time, especially if you have credit card processing capabilities on site. Other payment processes patients respond well to are online bill pay and automated payments.

2. Focus on comprehensive care and wellness

In addition to front-of-house improvements, you also need to change how you deliver patient care. A diagnosis and prescription won’t cut it anymore. Patients want a much deeper understanding of their health. They want a comprehensive approach to treatment something that teaches them healthy behaviors they can continue after their treatment is over.

The desire for these long-term solutions is the result of the challenges today’s healthcare consumers face. It’s much harder for them to access care, and the cost of care is a big concern for patients as well. In fact, a recent study states 40% of Americans skipped a recommended medical test or treatment in the last 12 months due to cost.

Additionally, Americans fear the cost of treatment more than the potential illness. When they do seek care, they’re looking for the best, most well-rounded and effective treatment they can find in order to prevent future healthcare costs.

3. Boost revenue with CMS value-based quality care initiatives

If patients avoid healthcare and only engage in comprehensive treatment, what does that mean for providers? CMS is aware that providers may be concerned about losing revenue, so they’re rolling out value-based initiatives to ensure both providers and patients benefit from this transition.

If providers can prove that they’re creating comprehensive health plans and focusing on the long-term well-being of their patients, they’ll receive payment. The qualifications and terms of each CMS plan is unique, but the opportunity is there (or on its way) for providers to increase the level of patient care they provide without hurting their revenue.

The shift toward offering higher-quality care in a more accessible manner has already begun. If your organization has yet to make the necessary adjustments to embrace value-based care, now is the time.

For more on the value that value-based care is bringing to providers, patients, and payers, check out our blog on how this approach improves health outcomes, quality, and experience.

Inovalon® and design, Inovalon® are trademarks of Inovalon, Inc.

About the author

Michelle Karl, Solution Architect