How independent practices can move toward value-based care

With healthcare costs rising astronomically, the move toward value-based care offers independent physicians the opportunity to be reimbursed not just for the number of patient visits but for the quality of the patient’s healthcare outcomes. Independent practices can move toward value-based care in a way that will improve their level of care as well as their financial stability.

Annual healthcare spending in the US is now more than $3.5 trillion. The move toward value-based care is one way to help reduce these costs. In addition, during the COVID-19 pandemic, the number of patient visits has been significantly reduced, leading to reduced income for many practices still on a fee-for-service model. The value-based care model will enable independent physicians to be reimbursed for the quality of their healthcare services and not just the volume.

The transition to value-based care for the independent physician could mean a premium for making thoughtful care decisions that result in improved care for the patient. It could also mean being able to treat patients with more conservative therapies as opposed to higher acuity procedures, where appropriate, resulting in more effective cost management. The provider will also have the opportunity to provide input into future healthcare delivery models.

Independent practices can move toward value-based care over the next few years by focusing on three areas:

• Incorporate a standard for enhancing data collection and reporting within the practice. Having this data available to be sorted and analyzed enables the independent practice to track changes in outcomes based on adjustments in treatment approaches. Focusing on existing data can be essential to a stronger bottom line for the practice.
• Define key performance indicators that would lead to improved patient outcomes and lower costs for the practice and for the patient.
• Assign a member of the practice’s staff to work with the data collection, incorporating a constant improvement process into the practice to lay out a plan for transitioning to value-based care.

Delaying the move toward value-based care can negatively impact the business side of the independent practice and possibly even the quality of care provided to patients. Fee-for-service contracts are beginning to decline, although many independent physicians are still hesitant to take the risk involved in the value-based care model.

The Deloitte Survey of US Physicians from 2020, 2018, 2016, and 2014 reveals that:

• Physician compensation continues to emphasize volume more than value. Physician compensation comes mainly from traditional sources, and meaningful performance bonuses are the exception rather than the norm.
  • In 2020, as in 2018, almost all physicians (97%) relied on FFS and/or salary for their compensation and 36% also drew compensation from value-based payments.
  • The proportion of physicians (23%) who receive performance bonuses of more than 5% also hasn’t changed.
• Availability and use of data-driven tools to support physicians in practicing value-based care continue to lag:
  • Only one in two (51%) physicians are aware of the costs of treatments they select.
  • Almost half (48%) are comfortable discussing costs with patients.
  • Just under half (46%) say they follow clinical pathways adopted at their organization.
• Existing care models do not support value-based care and many untapped opportunities remain for improving the quality and efficiency of care.
• Physicians estimate significant portions of their work today can be performed by nonphysicians (30%) in nontraditional settings (30%) and/or can be automated (18%).

Reassessing current risk models will help the independent physician avoid falling behind as the window for voluntarily switching to a value-based care model starts to close. Taking proactive steps to move toward value-based care enables the independent physician to benefit patients’ quality of healthcare outcomes and the practice’s bottom line.