By now you’ve heard about pay-for-value, which rewards providers for quality of care, not quantity. In fact, Ohio’s governor has established “Transformation of Healthcare Goals” for the state of Ohio to drive a payment system to Primary Care Physicians that focuses on quality of care rather than quantity of care.
Pay-for-value holds a single provider accountable for that patient’s care, regardless of who actually delivers the service. Under a pay-for-value model, the accountable provider is incentivized to improve the patient’s overall health and cost outcomes, regardless of the number of services provided.
It could be as simple as ensuring a patient takes medication as prescribed or schedules their preventive care screenings and blood tests, even if that results in fewer office visits.
HERE’S HOW IT WORKS:
A patient is assigned to a single accountable provider; this is often, but not always, their primary care physician. The accountable provider directs their patient’s care to other providers for things like diagnostic and outpatient procedures, consultations and rehabilitation. But the primary care provider is accountable for the outcomes.
The provider is given the tools and training to easily access and evaluate each patient’s medical records for potential risk drivers, care opportunities, and utilization trends. And they are compensated for time spent on care coordination and planning. So providers are no longer faced with choosing healthier patients or higher compensation.
These better outcomes translate to lower costs, with a gross savings of $9.51 per attributed member per month.
Pay-for-value members also report greater satisfaction with access, communication and the amount of time spent with providers.
Pay-for-value is transforming the way we approach health care.
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