Value-Based Care: Quality Over Quantity
Value-Based Care: Quality over Quantity
Value-based care is a method of reimbursement that links payments to the quality care provided and rewards the efficiency and effectiveness of providers. This reimbursement form has proven to be a possible alternative fee-for-service repayment model. Fee-for-service retrospectively pays providers for services delivered on the basis of billing or annual service fees. The Medicare & Medicaid Services Centers have introduced a range of valuable care options, such as the Medicare shared saving program and the pioneer accountable care organization models, in order to transform the way healthcare suppliers are reimbursed for services rendered. As a result, private payers have adopted similar accountable, value-based treatment models.
Navigating value-based care programs can be tricky – especially when it comes to reimbursement. Outsourcing your coding support, denials remediation, and other needs to an HIM-credentialed organization is the right step toward success. Contact YES HIM Consulting today!
What is Value Based Care?
In short, value-based care models focus on the patient’s results and the ways in which healthcare providers improve the quality of care using specific measures, such as hospital re-admissions reduction and the use of certified IT services. Review this CMS resource that explains more about value-based care programs. As the ever-transforming healthcare industry takes its next step into pioneering new ways of delivering care, providers ask one question. How is value-based care different from the traditional model and what are its advantages?
Value Based Care Model vs. Fee for Service
The traditional (fee-for-service) model of reimbursement pays healthcare providers based upon the amount of services they administer. Because of this, trends show for more procedures to be performed and a higher number of tests to be ordered. This will increase overall health care costs while not necessarily improving health care quality. As a result, value-based care programs drive down healthcare costs and potentially improve patient outcomes. The new, value-based models encourage providers to use evidence-based medicine, engage patients, utilize health IT as well as data analytics in order to get paid for their services. (recycleintelligence.com, 2016)
For many healthcare providers, this care model is still a fairly new concept. It goes without saying that it will take some time to become fully incorporated into the day-to-day workflow. But, with the huge potential to continue to decrease spending and improve quality of care, value-based care is definitely a method that isn’t going anywhere but up in the near future.
Navigating value-based care programs can be tricky – especially when it comes to reimbursement. Outsourcing your coding support, denials remediation, and other needs to an HIM-credentialed organization is the right step toward success. Contact YES HIM Consulting today!
