Helping to engage independent practices in value-based care

It's no secret that patients want their care providers to give them adequate time and attention to make sure that they stay healthy and their health care needs are met. For providers, we believe it is much easier to help achieve these goals through value-based care arrangements. However, making the move away from the traditional fee-for-service model doesn’t happen overnight — especially for smaller practices with more limited resources.

Value-based care allows health care professionals to be paid based on quality of care and patient outcomes, instead of the number of services a patient receives. This shift can also create financial incentives for the provider to spend more time, to focus on delivering quality care and to provide better care management and coordination for the patient. But no matter how desirable a value-based care model may look, getting started can feel overwhelming for smaller providers. Simply put — many independent practices may not have the support needed to make the switch.

“What we often hear from these smaller independent practices is the desire to provide better care, at the right time, in the right setting, but the administrative challenges may make it difficult,” said Dr. Jessica Bartell, senior vice president and chief medical officer of population health and value-based care for UnitedHealthcare. “By supporting their transition to value-based care with tools and resources, we not only help reduce the burden, but help ensure long-term success.” 

Implementing value-based care can require a comprehensive understanding of the health of your patient population, care coordination systems and data reporting. Often, independent providers may lack line of sight into patient care outside their practice and don’t have the same access to resources to invest in population health data.

Programs that collaborate with health plans to engage primary care providers (PCPs) and their staff to help guide this transition can remove some of the perceived challenges with making this change. For example, Practice Extend Program | Optum is a comprehensive program that enables health plans to engage PCPs on a path to value-based care while helping to drive return on investment. 

By creating interventions to help boost provider engagement, these programs provide a dedicated team to help coordinate care transitions, manage referrals to other specialists, engage resources to help address social needs and review medication, based on quality and cost saving opportunities. All while ensuring the care coordination is tracked and communication with providers is prioritized.

These types of programs can also help provide, clinical data insight and member risk segmentation to help monitor and manage population health. This, in turn, can help reduce barriers to care, identify opportunities to lower costs and assess effective care coordination interventions.

Consider what may happen after a patient is discharged from the hospital after a serious medical event. The patient may leave the hospital without a follow-up appointment and without clear medication instructions. At times, these issues may result in a costly readmission or, hospitalization for complications.  

With a value-based care approach combined with a care coordination program, a dedicated team can engage the patient post discharge to review and explain any new medications, emphasize the importance of medication adherence and make sure the patient’s care coordination or management questions are answered and that they understand their post-discharge care plan from their hospital provider.

During a care transition, a team can help identify members with complex medical conditions who may benefit from ongoing care coordination such as a future comprehensive medication review.

Creating value-based care solutions like this helps leverage technology and care coordination services to help ease the burden for providers of engaging in these types of arrangements, resulting in what we believe to be better quality care for patients while helping providers to deliver better results and succeed in value-based care.

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