Value-based care has been a focal point in healthcare for several years, and its importance continues to grow. Achieving value-based care success depends on building a strong partnership between health plans and providers.
When creating these programs, providers must commit fully, while health plans must prioritize patients and their care in the initiatives they implement.
This blog explores the importance of value-based care and how health plans can better engage and empower their provider partners in value-based initiatives.
What is value-based care?
Value-based care is a model that correlates the amount healthcare providers earn for their services to their patient results. This aims to create accountability and incentives for providers to elevate their care outcomes while compensating them accordingly. Plus, the prevalence and importance of value-based care success are only increasing.
Establishing trust between providers and health plans
Trust, communication and collaboration are essential drivers for respect, and control are essential drivers for a successful value-based program. Although both health plans and providers want to create and keep patients healthy, conflicting priorities can create confusion, so beginning the relationship with a strong communication foundation is essential.
Collaboration with providers in developing plans is key to understanding plan requirements and what providers can do to ensure the program's success. This is a great place to leverage quality and risk adjustment data. By teaming up with providers, health plans can create value-based care contracts centered around their patient communities and goals.
It’s important to consider what motivates providers, whether that includes clinical excellence, financial incentives, or benefits. By understanding these motivations, health plans can create programs that providers will be driven by from the start with strong buy-in. It’s also essential for health plans to support their providers throughout value-based care programs because some networks will have more resource support than others.
Creating transparent reporting and navigating complexities
Communication is key to creating a successful value-based care program, especially when it comes to reporting. More specifically, transparent reporting allows providers to understand their results and see their targets.
Clear and concise reporting can improve providers' awareness and make their contracts easier to understand. Reporting also helps identify patterns and insights that inform providers on how to tailor care to meet patients’ needs, ultimately having an immediate impact on providers.
Navigating complex reporting
Tracking value-based care program performance can often confuse providers, so it’s up to the health plan to ensure providers are accurately informed of their progress.
Health plans can solve this challenge by developing simple and easy-to-follow reporting. Providers want to quickly understand and digest these insights to determine what changes need to be made to impact the patient’s health outcome.
Although quick and clear reporting is essential, detailed reporting is also needed, which can be helpful for providers when they want to drill down into specific conditions or patterns. Health plans should provide this quarterly or more frequently, depending on the provider network's preference.
Personalizing programs for unique populations
Value-based care programs should be tailored to specific populations. Sometimes, this means that not all patient populations need a value-based care arrangement. By creating physician advisory boards to weigh in, health plans can ensure that the correct populations are included. Physician advisory boards can also support the creation of value-based care programs and help identify the necessary information to meet program goals and keep targets within reach.
By personalizing programs to fit unique population needs, health plans can create a value-based care contract tailored to the differing needs of patient and provider communities. Goals become more understandable and attainable when programs are aligned in this way.
Meet program goals with value-based care software
As health plans expand their value-based care initiatives, improving risk score accuracy without disrupting daily operations remains challenging. Fortunately, advanced technology can help streamline this process.
Inovalon’s Converged Provider Enablement software helps health plans capture complete and accurate documentation, ensuring the focus remains on member care and improving health outcomes for those with chronic conditions.
By aligning incentives, simplifying reporting, and personalizing programs for unique patient populations, health plans can drive better patient outcomes while ensuring provider engagement.
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