By 2016, the Department of Health and Human Services has a goal of having 30 percent of fee-for-service Medicare payments tied to quality or value through alternative payment models such as accountable care organizations (ACOs), value-based reimbursement, or bundled payments. According to the HHS news release on January 26, 2015, this will jump to 50 percent by the end of 2018. Is your organization ready to meet the challenge to achieve value-based care by next year?
In order to be successful delivering quality-based care, your organization not only needs to focus on process changes, but it also needs to engage others in a new way to change behaviors. This includes attitude changes in employees, employers, community members, and providers across the continuum of care to ensure success. Are you ready to make the behavioral shift necessary to provide team-based care that delivers quality outcomes?
In general, there are six key behavioral shifts that can help propel your transformation strategy and move your organization toward value-based, collaborative care across the continuum of providers.
- Develop greater collaboration between providers and payers. There are different ways to achieve collaboration depending on your objectives (whether to remain independent, join other ACOs, etc.). Your organization will need to determine what models of collaboration are appropriate given your strategic objectives.
- Initiate greater collaboration with employers and the community. Greater consumer engagement, employer-driven incentives, retail clinics, and other measures all help support the move to better population health and better outcomes at lower costs.
- Embrace technology applications for process improvements. There is much technology can do to help your organization transform care delivery. You can use technology to track, monitor, and report quality to Medicare (or face penalties) and leverage real-time access to clinical data, telemedicine, and health monitoring for new care delivery models. Technology can also help you improve patient care by automating tasks for appointment follow-ups, patient reminders, and preventive reminders for physicians and patients. You can also create patient portals to maintain communication and monitor care plans. Consider using a contact management system to track your patient activities.
- Explore new care delivery models. Organizations must change how care is delivered as they shift from delivering episodic care to managing the total health care needs of a patient population. The goal is to provide the right care, at the right time, in the right place with an emphasis on achieving or maintaining a desired health status.
Managing the total health care needs of your patients requires an expanded team approach to care, whereby providers work at the top of their license and expertise. Such teams may include advanced practice clinicians, care managers, social workers, pharmacists, nutritionists, and health coaches all working together under the leadership of physicians. It may further require changing facilities and adapting spaces to accommodate the care team approach and patient flow.
- Gain insight into the minds, and needs, of your customers. To understand how your customers, (your patients), grade your delivery of care, you need to thoroughly understand the “voice of the customer.” This is a term used to describe the verbal feedback your patients give you and also the data gathered from observations, complaint logs, and surveys. Your patients start grading your organization from their first interaction and this continues throughout their entire relationship. Incorporate feedback mechanisms at every level of the relationship and analyze this data to continuously understand how your patients value your services. Share this feedback with all in your organization.
- Migrate physicians and other providers toward a relationship building model. Physicians and clinicians need to move from telling and prescribing to coaching and educating. They will need strong communication skills as well as other soft skills in order to actively engage patients in their care for better outcomes and lower utilization of resources. All providers should be trained on and skilled in building strong, trusting, lasting relationships with patients and families. This doesn’t stop after the patient leaves your facility. It needs to be a continuous effort of engaging and re-engaging your patients.
Transformation is underway
Many health care organizations are already successfully shifting behaviors and improving outcomes. They are firmly focused on costs, but are also investing in innovation. By committing to both, they are proving that it is possible to improve patient value and make population health work.