Is your practice or hospital ready for value-based payment arrangements?

In September 2017, HFMA conducted a survey of their members to understand organizations’ value-based payment readiness[1]. The survey involved 117 senior financial executives. Because the survey focused on senior financial executives, many points left me wondering if the clinical and operational leaders of our hospitals would feel similarly. For example, the survey found that in general, financial executives do not view their organizations as highly capable in the areas that support value-based payment (see Figure 1 below).

Do you think the clinical leader of the transition to home clinic at your hospital would agree that they are only “somewhat capable” in post-discharge follow-up? How about your analytics team? Do they feel that their team is only “somewhat capable” in the area of business intelligence? Maybe your technology team would agree that external interoperability is an area that could be improved upon but general interoperability is an area of strength.

It is extremely important that all departments across the organization collaborate on initiatives to prepare for value-based care. Here in Maryland, hospitals are paid on a global budget. This is the foundational form of a value-based contract, certainly a departure from the customary fee-for-service model. Financial leaders are well-versed in the budget determination and strategic planning for optimal outcomes under this unique model, but how involved are the clinical, technological, and operational leaders? It is important to align incentives and commit to a culture of population health in order to succeed. As the HFMA article points out, one downside of the shift to value-based care is its sluggish adoption rate. When organizations are forced to split their attention and effort between fee-for-service and value-based care models it can lead to a complicated environment both administratively and clinically.

We see this tension regularly in our work with practices who engage in both fee-for-service and value-based contract arrangements with payers. Make sure your organization is prepared for success. Learn the most important areas of focus to coordinate clinical, financial, and operational strategies for success. Every organization is different and every organization can succeed. Let us customize a solution for you.

[1] Value-Based Payment Readiness. hfm. April 2018