Success in a value-based services environment requires physicians to: (1) continue improving the quality of their services, and (2) provide those services in an efficient manner to reduce the cost of care. In addition, physicians and ambulatory networks must strive to be high-performing in order to earn shared savings.
A recent Healthcare Financial Management Association (HFMA) article focuses on three key factors needed to be a high-performing network:
- Defining your service portfolio: Service offerings can be presented as different tiers or levels. Networks may offer a broad array of services from prevention to surgery including primary care and specialists, or they may focus on extensive services for a specific set of diagnoses such as cardiac or orthopedics, or they may provide a limited service offering such as women’s health services.
- Innovative delivery models: This includes structuring appointments and designing facilities to better serve patients. Technology improvements, such as an online patient portal, also allow patients to schedule their own appointments online, obtain test results and manage medications.
- Consumer orientation: Patients expect a community-based primary care environment. Access to appointments should be within a 24 to 48-hour window, parking should be available at the entrance level, and pricing should be a fair market value’s median for paying out-of-pocket costs in order to compete with urgent care centers and retail niche clinics.
Healthcare is undergoing some major changes on how physicians will be paid in the future. Planning now to improve the performance of your practice while lowering the overall cost of care will assist you in the transition from a fee-for-service to a value-based environment.