Medical Billing Companies In California

Value Based Reimbursement

Even though majority of the healthcare providers and organizations are working to find ways to restructure physician productivity strategies, payers are pushing for better value-based reimbursement adoption. As healthcare providers aim to meet the unique requirements that are necessary for performance-based payments, Cathryn Connolley, managing partner at SystemCare Health, has advised healthcare organizations to align physician productivity goals and patient experience to succeed under these conditions.

“The shift from volume-based care to value-based care has most healthcare systems scrambling to find efficiencies and marry them to customer expectations. Incremental productivity gains that come from old school hospital improvement efforts in productivity and revenue cycle help, but aren’t enough to allow for success in the new value-based world,” Connolley said in a press release.

A few similar concerns were shared in the report from Congressional Budget Office report last month. Researchers discovered that the only way for hospitals to maintain profitability under the Affordable Care Act is by developing new strategies to boost the productivity from 0.5 percent to one percent. However, a report from the Health Care Financing Review study revealed that the average annual productivity growth percentage in hospitals between 1996 and 2005 was 0.3 to 0.6.

Medical Billing Lytec

Physician Productivity Goals

Connolley said that hospitals must analyze value-based care metrics in order to improve their productivity. Traditionally, physician productivity was defined only using the relative value units (RVUs), but now, there are many more factors, such as access to care and patient satisfaction, that should be considered for value-based reimbursement.

“With patient satisfaction having a tremendous impact on the reimbursement rates in the new value-based care model, access to care is a critical metric for productivity. We find that more and more healthcare systems either currently or need to restructure their contracts to focus on a combination of productivity goals, like RVUs, patient satisfaction, and access to care,” Connolley stated.

Healthcare organizations now have to monitor different patient experiment measures, such as the rate of cancelation, no-show percentage, and how long does it take for a new patent to approach a provider, due to the value-based reimbursement models. According to Connolley, healthcare providers need to use these factors to alter the physician productivity strategies and align them with patient expectations. However, she also admitted that some healthcare organizations might find it difficult to break the barrier between care delivery and healthcare business.