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To Prevent VBP Financial Loss, Think Like a Clinician

Karen Minich-Pourshadi, for HealthLeaders Media, October 31, 2011

Healthcare financial leaders and clinicians have traditionally worked in their own silos, running into each other occasionally but rarely seeing eye-to-eye. Yet they now must work together to achieve the goals set forth in the federal value-based purchasing rule.

Currently, VBP rules hold healthcare organizations accountable for 12 process of care measures and HCAHPS. Next year, however, mortality rates and hospital-acquired-conditions will be added to the mix. To meet both the medical and financial imperatives of VBP, financial leaders will need to go beyond their usual scope. Look through the eyes of the clinicians to improve patient care and prevent reimbursement losses.

"Most CFOs are concerned with the negative consequences of VBP, because if you don't comply you get a reduction in reimbursements," says Bruce L. Van Cleave, MD, senior vice president and chief medical officer at Aurora Health Care in Milwaukee. "But, on the medical side we need to concentrate on patient safety and high quality care. If we aren't careful, when we [each] talk about value-based purchasing we could be having two very different conversations," says Van Cleave, who is also the former president and CEO for Carondelet Health in Kansas City and a board-certified family practice physician.

Van Cleave's clinical and administrative background helps him see VBP from both vantages. Taking a broader perspective can help financial leaders prevent VBP reimbursement losses.

"I wish the ongoing conversation we were having [with financial leaders] was, 'How do we use this to re-look at our strategies around care delivery?'" he says. "And that we'd broaden the discussion away from, 'How can we maximize our reimbursements?'"

Van Cleave believes that if healthcare leaders concentrate on understanding the intent of the VBP law, they will find the answers to their reimbursement concerns.

"Think about why the government wants us to do this. What outcomes are they really trying to get at? Certainly one outcome is to control cost, but it's not all of it. … What impact will this have on how healthcare will be practiced in the U.S.? And, how can we link our outcomes and our finances so they are strategically aligned?" he asks.

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