To Survive in Value-Based Healthcare Model, We Must Learn to Work with Clinicians Outside of Our Own Silos

According to a recent article published in Forbes, "The move to population health and away from fee-for-service medicine is working to the detriment of U.S. hospitals, a new report from Fitch Ratings indicates.

Many would argue that the move to value-based care is a good thing because it’s designed in part to eliminate unnecessary tests, procedures and inpatient hospital admissions long considered a waste when pay is based on volume of care delivered. The Fitch special 2018 report on nonprofit hospitals and health systems shows an industry slow to adapt to these changing reimbursement models.

Health insurers and the government are increasingly moving away from fee-for-service medicine to value-based payment models that measure outcomes and stress population health strategies designed to make sure patients are getting care in the right place, in the right amount and at the right time. This trend is designed to keep people out of the hospital, shifting reimbursement to outpatient models and putting hospitals at greater financial risk."

Change is hard. Healthcare is in a particularly difficult spot right now. We are spending about 1/5 of our GDP on healthcare, and yet hospitals have no money to transition to value-based care.

Currently, hospitals and other healthcare entities are asked to manage a system with one foot in the volume or fee-for-service world and the other foot in the value-based world. NO WONDER WE ARE STRUGGLING.

Providers, payers, and industry must all work together. We must also realize that most patients transition through multiple different healthcare entities while receiving care. In order to survive in the value-based world, we must learn to work with providers outside our silos.

Data interoperability is key BUT so is real-time communication. Time sensitive emergencies are a great example. THEY ARE OUR LAST OPPORTUNITY TO PROVIDE PREVENTATIVE CARE. Patients can rapidly transition through multiple healthcare entities, and communication and a systems of care approach is critical.

A patient's outcome (and therefore reimbursement) is often determined more by what we do together rather than by what we accomplish for our patients in our silos. The future of healthcare communications is connected teams.