Unlike the traditional system in which patients pay based on numbers (how many visits, treatments, tests, etc.), a value-based care (VBC) pay system is based solely on the quality of care. The concept is designed to decrease the amount that patients pay for medical care without reducing the actual quality of care.
Like many health care providers, you may not be ready for the transition because you’re not sure how to prepare. While your priority remains unparalleled patient care, the experts at ML Medical Billing can create a customized plan to get your practice ready and turn your concerns and challenges into advantages that boost your bottom line.
Now is the time for due diligence. Choose the best providers, find incentives that are both mutually agreeable and beneficial, and invest time and money in building the best business model that maintains your expert patient care and maximizes your revenue potential.
Benefits of Value-Based Care Models
Although many in the medical industry believe that a value-based care system is viable, not all models are the same; a plan that suits one practice might not be the solution for another practice.
In taking advantage of a value-based program, your practice will likely experience the following benefits:
- More efficient billing processes
- Streamlined payment collection
- Reduced costs (e.g., overhead)
- Increased profits and profitability
- Rewarded for quality patient care
You may be wondering, though – is there a one-size-fits-all value-based care model? Or is there a more customizable one that’s right for your practice? Let’s take a look at several possibilities.
Common Value-Based Care Models
The following are examples of models currently in place (with others in development), each of which has its own guidelines and benefits. Yet, the overall goals of each system are still the same:
- Maximize reimbursement
- Implement and take advantage of shared savings programs
- Decrease the costs for more efficient quality patient care
- Increase the number of patients
Patient-Centered Medical Home (PCMH)
As much a model of care as it is a place of care, the patient-centered medical home model features patient-centered care that is both comprehensive and coordinated, with accessible services that ensure quality and safety.
Patients receive the care they deserve and expect from a team of professionals, including access to after-hours care, when necessary, that eliminates the hassles, stresses, and expenses of emergency room care. In fact, many are able to access effective treatments according to their cultural beliefs or personal preferences.
With PCMH recognition or accreditation, perhaps you can benefit from various incentive programs, shared best practice advice, and other strategies and methods that lead to patient satisfaction and increased patient volume. Preventative care, decreased ER visits or hospital admissions, and management of chronic diseases are among the top goals of this model, allowing you to focus even more on patient care.
Accountable Care Organization (ACO)
A healthcare provider network of coordinated care and shared medical and financial responsibilities, an accountable care organization (ACO) is designed to provide high-quality patient care (particularly the chronically ill), avoid unnecessary services, and prevent errors.
Medicare, Medicaid, and private payers, like Cigna and Aetna, have their own type of ACOs. Provider members collaborate to develop and deliver the best patient care for successful outcomes and are evaluated on their effectiveness in the care they provide. Accountability is at the provider level, which can help pinpoint inefficiencies in care and care costs. Under this model, solutions from ML Medical Billing can be designed to relieve practices of the burdensome hassles of documentation and reporting so you and your staff can focus on patient care.
Although these are two of the most common VBC systems, there are others that could be more suitable for your practice. Talk to ML Medical Billing about your needs and preferences to figure out the best model for your practice.
Learn more about ACOs at Wikipedia.org.
Why ML Medical Billing?
The VBC models are challenging the roles, methods, and practices of the traditional health care system. To thrive, not just survive, a practice must evolve and integrate itself into a suitable VBC system by implementing necessary technology and data systems while maintaining unsurpassed patient care.
The shift toward a VBC system presents never-before-seen opportunities and challenges, but with ML Medical Billing, your practice can successfully make the shift. Our training, experience, and knowledge can be crucial in helping you deal with the ongoing changes that will impact your practice in the following ways:
- Updated billing methods
- Enhanced collection techniques
- Ready for difficult transitions
- Outsourced team of dedicated professionals
- Customized processes that simplify all procedures
- More consistency, security, and accuracy
Our services free up time and resources so you can focus on patient care that results in a more streamlined business with reduced costs and increased profits.
Contact ML Medical Billing to Help You Prepare for the Future of Value-Based Care
Regardless of the model, your first priority is providing top-level patient care, but you also must stay profitable. The VBC model is here and if you’re not ready for it, you could be risking your future. ML Medical Billing has the experience and knowledge needed to deal with these challenges and leverage the opportunities. To learn more, contact ML Medical Billing by calling (888) 719-7602 or by contacting us online. We have offices in Illinois, California, and Florida, but serve practices throughout the United States.
Next, read our May 2017 Newsletter