Key Steps for Specialty Practices to Thrive in Value-Based Care

May 24, 2017

The transition to value-based care has proved challenging for providers of all types. Specialists, however, are faced with completely transforming their practice operations to both comply with and thrive under new government programs, like MACRA. The good news is, specialists are uniquely situated at the intersection of cost, quality and patient experience that these programs are designed to address, presenting a valuable opportunity for those practices that embrace it. To help specialists ensure success in the era of value-based care, we outlined a few key steps for them to keep top of mind:

  1. Treat value-based care as a clinical and financial opportunity.
    We understand how easy it can be to view value-based care as yet another regulatory burden, but the potential of value-based care (e.g. OCM, APMs, etc.) to significantly improve clinical outcomes for patients, as well as positively impact practices’ bottom lines is pretty substantial. In fact, the highest-performing practices under MACRA can achieve a 19% increase in their reimbursement, with the possibility of further bonuses based on a share of savings achieved.
  2. Be proactive in determining the right value-based care path.
    There are many options for specialists participating in value-based care, so strategic decision-making is essential. Determining which programs to participate in under MACRA is one of the most important – and confusing – decisions facing specialists today. We conducted proprietary analyses that found those that participate in both MIPS and advanced APMs will see the greatest potential upside. But, the most ambitious path is not always the right one. We encourage practices to take inventory of their options and calculate the potential risks of each to help ensure optimal returns.
  3. Commit to practice transformation in support of success.
    Few specialists doubt the necessity of new investments to accommodate value-based care initiatives. As specialists assume more responsibility for the holistic care of their patients, the need for alternative or additional technologies and staff to meet newly determined objectives will become much clearer. For example, population health management and analytics capabilities will be increasingly useful tools for specialists that need to efficiently identify high-risk, high-cost patients in this new landscape.
  4. Measure progress and look to optimize results over time.
    In our view, perhaps one of the biggest advantages a specialist can have in value-based care is the ability to track their progress and performance in real-time. Those practices that can accurately project their scores, and pivot strategy as needed, will have the best chance of optimizing results over time, outperforming their peers and ensuring overall success.

While unfamiliar territory for many specialists, fulfilling the promise of value-based care is a ripe opportunity to take real ownership of the health of their patients and practices alike.
Read our CEO’s article here for more in-depth information.