Almost a decade in, the race toward physician alignment has both hospitals and physicians fatigued. But by shifting the conversation to value-based care, the goal finally appears within reach.
The race for hospitals and physicians to align has been rampant for almost a decade now. After any race, comes fatigue and that's what we're seeing today.
Historically, these alignment strategies have been heavily weighted on financial projections as opposed to a balanced value-based approach.
And while some of the alignment strategies have been successful, many have resulted in poor economics, increasingly distrustful relationships, and others are still impatiently waiting to realize the promised returns.
In contrast, a value-based program that focuses on putting quality care and providers first, naturally serves as an effective alignment strategy. In fact, Global Healthcare Alliance clients who have leaned on their value-based programs to strengthen physician relationships experience an increase in market share.
Shifting the conversation through market data and analytics and creating an alternative payment model that is tracked and measured moves physicians to feel connected to the overall program.
With this foundation of trust, health systems, physicians, and payers are working together to deliver the best care experience possible. Rather than feel fatigued by the process, all parties get a much-needed boost and clear direction for a successful future together.
Here are a few simple considerations when seeking to tighten physician relationships in your market:
1. Help remove barriers to care
Physicians are just as frustrated as patients when it comes to lack of access to care. Challenges with payers, lack of investment in technology, and outdated practice operations all lead to high frustration levels. Helping physician leap to new practices that recognize patients are also consumers is extremely helpful in alleviating some of this stress.
2. Seek support from local employers
By building strategic partnerships and centers of excellence programs or destination of care centers, you're engaging physicians as part of a tight care network where incentives are aligned, and patient outcomes improve.
3. Facilitate alternative payment model discussions
Bringing in a trusted expert from outside your organization to assess your market's highest healthcare needs and provide data creates an opportunity for sound discussions around alternative payment models.
Ultimately this transparency helps everyone to land on the same page.
4. Create a new system for alternative payment models
Once an alternative payment model with a good operational structure is agreed upon, it's important you stand it up using the right partner and technology that will effectively administer the program.
If the programs waivers, you lose physicians' trust. With the right structure, the program will succeed and create financial sustainability for the long term.
Physicians have more than ever on their plates. By trying some new strategies to engage and support them, that also advance your organization on its path to value, you're creating an entirely new environment –one that's not a race, but rather, a journey taken together.
These four steps help healthcare providers, insurers, and employers build successful alternative payment models.
At Global Healthcare Alliance, when we first engage with a new client, one of the primary issues we hear is that they are struggling to move their value-based strategies along because employers, payers, providers seldom agree.
This is certainly understandable, since historical alternative payment models have many times concentrated too heavily on cost discounts versus a balance of quality, care and value.
It's no wonder why so many then shy away from jumping in to a shared-risk model.
In our experience, by following these four steps, employers, payers and providers can establish the transparency and trust needed to build a successful alternative payment model.
1. Identify the Opportunities
It's all in the data. By analyzing patient population trends and demographics in comparison to care access, care utilization and provider participation, you create a foundation for developing a balanced alternative payment model that can be a fit for all.
2. Build the Programs
Lay a solid foundation. All too often, value-based programs are established and the supporting infrastructure is not defined to effectively govern and administer the programs, even with the smallest volumes.
Having a solid infrastructure in place is crucial to the success of an alternative payment model.
3. Operate the Programs Efficiently
Traditional fee-for-service processes and technology will not be effective for a sustainable value-based program.
Managing the patient, provider, and payer experiences in a value-based program requires a deep understanding of how value-based programs operate, not to mention technology to aggregate multiple episodes of care and allocate and manage risk distributions.
4. Optimize the Performance
After a value-based model had been implemented, the ongoing monitoring and measurement of its performance, based upon key performance indicators, maintains alignment and engagement toward the success of the program.
I think we can all agree, value-based models are here to stay. With the right strategy at the onset, healthcare organizations can avoid the pains that erode trust along the way.
Our experience tells us, that the result is a financially sustainable and clinically successful value-based care program that benefits payers, providers and most importantly, patients.
