Nearly six years after passage of the Patient Protection and Affordable Care Act, the healthcare industry is in the midst of a massive retooling that is dramatically altering the way we think about cost management, strategic partnerships, and customer service.
Fee-for-service reimbursement is giving way to new models of care delivery and payment to support a system based on pay-for-value. With financial risk or payments tied to value measures (such as patient satisfaction, clinical performance, and population health), compensation and reimbursement will increasingly be tied to value-based incentives.
With the inception of Value-Based Purchasing, the measurement of successful patient care delivery has been redefined. The move from fee-for-service to pay-for-performance means that reimbursements are tied to the quality of care that is delivered.
No matter how these issues are resolved, the new health care reality demands that providers deliver quality care while controlling costs. Use these six steps to bring success to your organization in the new reimbursement landscape:
1. Understand Your Costs
2. Reduce Out-Migration from Your Network
3. Maximize Pay-for-Performance Reimbursement
4. Identify Early Opportunities for Utilization Reductions
5. Support Chronic Care and Disease Management
6. Predict Who Will Develop Issues