172x Filetype PPTX File size 1.07 MB Source: grhainfo.org
Agenda www.shpllc.com 2 First and Foremost www.shpllc.com 3 1 Health Affairs Value Equation www.shpllc.com 4 VBC Defined Cleveland Clinic Value-based care is simply the idea of improving quality and outcomes for patients. Reaching this goal is based on a set of changes in the ways a patient receives care. We’re looking to make healthcare proactive instead of reactive, preventing problems before they start. Revenue Cycle Intelligence Value-based care is a form of reimbursement that ties payments for care delivery to the quality of care provided and rewards providers for both efficiency and effectiveness. CMS Value-based programs reward health care providers with incentive payments for the quality of care they give to people with Medicare. These programs are part of our larger quality strategy to reform how health care is delivered and paid for. Value-based programs also support our three-part aim: Better care for individuals, Better health for populations, Lower cost. UVA Sponsored – State Healthcare Cost Containment Committee Report (2014) The goal is straightforward but ambitious: Replace the nation’s reliance on fragmented, fee-for-service care with comprehensive, coordinated care using payment models that hold organizations accountable for cost control and quality gains. www.shpllc.com 5 Defining Value Based Care Value Based Care has no single definition At its most basic, VBC is ‘intended’ to be improved outcomes for less money. Who’s Doing the Defining – Patients / PCP’s / Specialists / Payors / Health Systems ? Variables: Type of population: Medicare/Medicaid/Commercial Type of Insurance: HMO, PPO, Narrow Network Type of Provider: PCP, Specialist, Hospital Market environment / pulse www.shpllc.com 6
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