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Transiting to the Value-based Care Reimbursement

Editors Note | Care Reimbursement | Insights Care

The revenue cycle in healthcare has been following the fee-for-service reimbursement strategy for a long time now. According to various healthcare experts, this process has proven to be very time-consuming. Patients are paying more for the out-of-the-pocket services, which are not very beneficial, and opting less for the necessary services. All of these concerns call out for a change in the existing revenue cycle management system. This is where the value-based care reimbursement strategy comes in.

The value-based payments bring to us the opportunity to lower the cost of patient care while improving the quality. The process is solely based on charging medical bills for positive clinical outcomes. Not only does it increase the sense of accountability in healthcare organizations, but it also shifts the burden of financial responsibility from payors to providers.

The question that arises is – can we do this? Yes! Although, the transition from fee-for-service to value-based payments is not easy, it is definitely possible. A few strategies can help make the process faster and smoother. Data analytics play a major role in analyzing quality metrics of an organization and monitoring its progress. This will help in keeping track of the quality of the services provided. The medical bills can then be tied to outcomes of those services.

Alongside, healthcare companies should promote collaboration among its several professionals, like nurses, doctors, finance managers, and so on. Often, due to lack of sync between these role-players, the payment process becomes confusing and is delayed. Also, front-end revenue cycle tasks are to be paid attention to. If the patients are educated about their financial responsibilities at every step, the transparency and ease in the entire process can be maintained. Population health management is another factor to be considered. Providing preventive and post-treatment care can aid to this.

As it is said, change is the only constant thing and such a change for better results is today a necessity in healthcare. By adopting value-based care reimbursement system, the industry can holistically improve its revenue cycle.



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