Today’s health systems live in two realities: traditional, fee-for-service reimbursement and value-based care payment models. The latter reality requires health systems to take on more clinical and financial risk — all while finding ways to maximize payment in the former reality. To do so, they must find ways to optimize performance as costs rise, reimbursements drop and governmental regulations dictate higher quality of care.
The journey to value-based care is built on three key strategies:
- Optimizing performance to align clinical and revenue cycle workflows for faster and more accurate payment
- Preparing for change by redesigning care delivery models to benefit from outcomes-based reimbursement
- Investing new capital to transform the quality and effectiveness of the care provided to patients
Health systems need to map the right strategies to ensure financial stability as they shift from simply providing care to managing the health of individuals and entire populations. Doing so will allow providers to better control how their organizations focus on quality while they manage more of the financial and clinical risk.
In my next two posts, I’ll focus on how providers are optimizing performance by addressing administrative inefficiencies and creating more patient-focused revenue cycle management processes.
To see how health care organizations can manage the shift from fee-for-service to fee-for-value, download the Optum white paper, “Mapping the journey to value-based care,” here.
About the Author:
Leslie Cozatt currently serves as Director of Marketing, Optum Provider – Thought Leadership and Content Strategy.
She directs the development of content that spotlights the role of data analytics in healthcare – specifically the transition to value-based care, risk management and population health management. She brings to her role more than 20 years of experience developing B2B and B2C integrated marketing campaigns for companies including ThreeWire, Eliance and 3M. Leslie attended the University of Minnesota and graduated from Wellington College with a BS in International Business & Communication.