CMS Says Value-Based Reimbursement
Is Now The Imperative. Are You Ready?
The stakes have been raised for payers and providers already besieged by a rapidly
changing market. In January, HHS announced targets to make alternative payment
the standard for 30% of Medicare reimbursement by 2016 and 50% by 2018.*
Is your organization ready?
To help you get ready, here are the…
Top 10 Things Payers and Providers
Can Do to Start Aligning with VBR
1
Take the plunge
together
Value-based delivery
changes depend on
value-based payment
changes. Payers and
providers must align to
enable value-based models.
4
2
Multiple payers in a
region are needed to
make it worthwhile for
providers to participate
in VBR in an efficient
and automated fashion.
There’s no time like the present to engage with
employers in the discussion about value-based care
and payment. They’re interested in strategies that
use incentives to reduce cost and improve care.
6
Target one or two areas
of reform to get value.
Some organizations start
by focusing on using
episode-of-care for hip
and knee replacements.
9
Find a neutral
party
Convene an open forum facilitated by a
neutral party so stakeholders can speak
freely about ideas, models, and plans.
5
Reach out to
employers
Stay focused
3
Build a critical
mass
Find seed
money
There’s been a wave of grants that promote
healthcare delivery reform. Look for federal,
state, and foundation grants for pilot
projects on delivery system reform.
7
8
Have a 5-year
plan
Create a long-term
strategic road map
that details where your
organization needs to
be by 2020, and how
it’s going to get there.
Adopt the new
technology
This change in healthcare delivery is happening now because we
finally have the technology to make it happen. Address IT in four
key areas: process reengineering and automation, connectivity,
analytics, and decision support.
2020
10
Educate your
organization
Find VBR evangelists
in your organization
(such as medical
directors) who have
a key leadership role and are skilled in
building coalitions.
Choose the
right partner
The way to scale VBR models is to automate the end-to-end process
associated with them. Most organizations can’t do this alone.
Find a partner who understands the challenges payers, providers,
and clinicians face in the transition to value-based models.
A shift to value will usher in a new standard of quality, affordable healthcare for payers, providers,
and patients. It’s time to invest in the models and technology that support VBR transformation.
Let’s work together to create a healthcare system that speeds our transition to value for better health.
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Top 10 by McKesson is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. Based on a work at MHSdialogue.com.
Permissions beyond the scope of this license may be available at MHSdialogue.com. *Source: “Better, Smarter, Healthier”, HHS.gov, January 2015, http://tinyurl.com/HHS-2015-Jan.