When it comes to transitioning to value-based reimbursement, health systems consistently ask two questions:
- Why should I invest in reducing utilization when 90+ percent of my business is still fee-for-service (FFS)?
- Where do I start?
This value-based reimbursement road map can help systems transition from barely surviving to successfully arriving (while respecting both shared-risk and FFS worlds):
Stop #1: Surviving
— If you don’t get paid for the risk you take on, then you can’t survive long term.
Stop #2: Sustaining
—Numerous clinical interventions occur in hospitals that systems can focus on to help improve the bottom line.
Stop #3: Succeeding
—Build out competencies on a smaller population with aligned incentives so you can negotiate deeper alignment with key payers.
Stop #4: Arriving
— The ultimate destination, where the lines between traditional healthcare delivery and public health are blurred.
Although healthcare is far from arriving at the value-based reimbursement destination, it can use this road map’s pragmatic strategies for heading down the right road.