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Value-based care can drive meaningful improvements in patient care by aligning payment with value. While many payers have value-based care programs, differences in structures and requirements can leave practices with an unbalanced focus on program requirements. Creating a quality and value-based care strategy allows practices to harmonize various programs ensuring high-quality patient care while minimizing practice burden.

 Creating a Quality Strategy

Successful performance in value-based care programs can be defined as improved quality of patient care and outcomes, a reduction in the cost of care for patients, payers, and employers, and the realization of financial benefits tied to performance. Creating an overall quality strategy keeps the practice focused on the key initiatives that can drive performance across programs.

• Build a strategy team that is inclusive and meets the requirements of the value-based program in which you are participating. Practices can no longer count on a single quality lead to manage performance; developing a strategy is a team effort and may include various practice members, as well as a quality committee with clinical and administrative stakeholders.
• Map out the requirements for all value-based care programs. Compare the similarities and differences in the data elements used to measure practice performance. Analyze how the score is calculated, and the methodology used to determine the financial benefit associated with the score.
• Review the current performance for each program, at the practice and individual provider level, to see where improvement is needed.
• Form your strategy by starting with high-level key drivers such as access to care, NCCN guidelines, care coordination, and end of life care, then drill down to the individual requirement and measure for each of the areas to identify specific action items for staff. Keep the patient perspective and care improvement at the forefront as you determine the priorities.

 Physician Engagement and Communicating the Quality Strategy

Once the quality strategy is created, a communication plan should be developed. Engage physicians and practice leaders first, then share the value-based care program overview and high-level details with the quality committee and other relevant practice committees. Share the value-based care program in detail with all providers and staff at each clinic. Team members responsible for change processes or creating new workflows should be engaged and help in communicating the new value-based care program including process, metric collection and monitoring, and ongoing performance. Updates should be shared consistently with the quality committee and sites on a consistent basis.

In addition to having a quality strategy in place, physician engagement is key to value-based care program success. When adding to or altering a physician routine, keep improved patient care and physician engagement at the forefront.  As physicians are challenged with shifting priorities, value-based care leads should keep them engaged rather than overwhelmed.

Practices that form an overall quality strategy and juggle the complexities of multiple programs will improve patient care and realize financial gains.

Learn more about managing value-based care programs here.

 

ABOUT THE AUTHOR

Toni Gress is the Commercial Value Based Care Lead for The US Oncology Network. She collaborates with Managed Care and the Transformation Leads to lead The Network practices in successful participation and performance in value-based commercial programs with the goal of improving quality and total cost for patients, providers, practices and payers.

Jay Scott is the Senior Director of Managed Care for Minnesota Oncology, a practice in The US Oncology Network. He is responsible for the development of patient experience strategy and quality improvement plans aimed at continuous improvement for patients, providers, payers and practices.