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Summary
A summary of the previous 5 topics regarding the transition from FFS to VBC.
Thank you!
Over the last several weeks, we have outlined the different elements to consider when making the transition from FFS to VBC. Here, we will do a quick review of everything you have learned so that you can return to this page to get a quick refresher.
What is the difference between Fee For Service (FFS) and Value Based Care (VBC)?
FFS is a payment model within the healthcare system that reimburses providers for the quantity of services provided. In this model, quality measurements are not taken into account. This means that providers can be incentivized to order more tests and procedures in order to increase the reimbursement they receive, despite the fact that this may not be necessary to improve the patient’s health.
VBC is a payment model in which providers are reimbursed based on the quality of care they provide, rather than quantity. This is measured via several quality metrics, including patient health outcomes and feedback forms. The VBC model is quickly growing in the healthcare sector, and CMS is pushing providers to adopt this model in order to improve patient outcomes while reducing costs.
Know Your Population
In making the transition to VBC, it is vital to understand the patient population and accurately identify the most unhealthy patients. This will allow a practice to pay special attention to patients with chronic conditions, who are on average much more expensive to care for than the average patient.
Design Your Team
The next important step in transitioning to VBC is designing the perfect care team. The perfect care team will require strong leaders, well defined roles, and clear methods of communication. It will also require team members that can fully understand a patient's medical history. Managing patient timelines, conducting pre-visit planning, and utilizing patient data to track valuable metrics is key to gaining a comprehensive understanding of the patient population’s unique needs.
Collaboration
Successful VBC reduces care fragmentation, which can be done by collaborating with other healthcare resources such as hospitals, urgent care clinics, primary care practices, and insurers. Two types of healthcare organizations have been formed to serve this exact purpose - Accountable Care Organizations (ACOs) and Direct Contracting Entities (DCEs). These organizations often utilize third party data applications that improve provider workflows and access to patient data such as longitudinal patient records.
Focus on Quality Improvement
A major goal of VBC is to improve the quality of patient care. This means that any practice adopting the VBC model will need to constantly monitor and assess the success of their practice against key quality milestones. As a result, the patient will be the center of attention, and all changes to care strategies within the practice will need to be led by physicians and agreed upon by relevant stakeholders.
Ongoing Monitoring
Adopting quality improvement tools such as Six Sigma or Plan-Do-Study-Act (PDSA) can help a practice monitor its success in meeting crucial milestones and health outcomes. Collecting valuable metrics about their patient population will be important in making these evaluations. It will also help if the practice has a dedicated data team member who can accurately organize and interpret the data.
All of these steps must be executed properly in order to ensure a successful and fluid transition from FFS to VBC. Now that you know what it takes, you’ll need to equip yourself with the proper tools to execute your own transition successfully. Accurately documenting diagnosis codes and tracking patient records will be a vital aspect of your practice, and Juxly Vault can help bridge that gap between the payer and the provider. To see how exactly Juxly vault can fit into your practice, schedule a demo with our sales team by visiting https://www.juxly.com/contact-demo.
Over the last several weeks, we have outlined the different elements to consider when making the transition from FFS to VBC. Here, we will do a quick review of everything you have learned so that you can return to this page to get a quick refresher.
What is the difference between Fee For Service (FFS) and Value Based Care (VBC)?
FFS is a payment model within the healthcare system that reimburses providers for the quantity of services provided. In this model, quality measurements are not taken into account. This means that providers can be incentivized to order more tests and procedures in order to increase the reimbursement they receive, despite the fact that this may not be necessary to improve the patient’s health.
VBC is a payment model in which providers are reimbursed based on the quality of care they provide, rather than quantity. This is measured via several quality metrics, including patient health outcomes and feedback forms. The VBC model is quickly growing in the healthcare sector, and CMS is pushing providers to adopt this model in order to improve patient outcomes while reducing costs.
Know Your Population
In making the transition to VBC, it is vital to understand the patient population and accurately identify the most unhealthy patients. This will allow a practice to pay special attention to patients with chronic conditions, who are on average much more expensive to care for than the average patient.
Design Your Team
The next important step in transitioning to VBC is designing the perfect care team. The perfect care team will require strong leaders, well defined roles, and clear methods of communication. It will also require team members that can fully understand a patient's medical history. Managing patient timelines, conducting pre-visit planning, and utilizing patient data to track valuable metrics is key to gaining a comprehensive understanding of the patient population’s unique needs.
Collaboration
Successful VBC reduces care fragmentation, which can be done by collaborating with other healthcare resources such as hospitals, urgent care clinics, primary care practices, and insurers. Two types of healthcare organizations have been formed to serve this exact purpose - Accountable Care Organizations (ACOs) and Direct Contracting Entities (DCEs). These organizations often utilize third party data applications that improve provider workflows and access to patient data such as longitudinal patient records.
Focus on Quality Improvement
A major goal of VBC is to improve the quality of patient care. This means that any practice adopting the VBC model will need to constantly monitor and assess the success of their practice against key quality milestones. As a result, the patient will be the center of attention, and all changes to care strategies within the practice will need to be led by physicians and agreed upon by relevant stakeholders.
Ongoing Monitoring
Adopting quality improvement tools such as Six Sigma or Plan-Do-Study-Act (PDSA) can help a practice monitor its success in meeting crucial milestones and health outcomes. Collecting valuable metrics about their patient population will be important in making these evaluations. It will also help if the practice has a dedicated data team member who can accurately organize and interpret the data.
All of these steps must be executed properly in order to ensure a successful and fluid transition from FFS to VBC. Now that you know what it takes, you’ll need to equip yourself with the proper tools to execute your own transition successfully. Accurately documenting diagnosis codes and tracking patient records will be a vital aspect of your practice, and Juxly Vault can help bridge that gap between the payer and the provider. To see how exactly Juxly vault can fit into your practice, schedule a demo with our sales team by visiting https://www.juxly.com/contact-demo.
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