HealthEC Blog Posts

Incentivizing Providers at the Early Stages of Value-Based Model Implementation

When asked about provider acceptance of population health management (PHM) initiatives, the leaders charged with implementing these programs are apt to say that most physicians see them as little more than an unnecessarily complex administrative endeavor instead of a tectonic shift in how health care will be delivered over the next several decades.

With that, administrators sometimes have difficulty getting physicians to discuss transitioning to value-based reimbursement models, let alone buy into the plans.

The reasons?

Some providers have known no other way than the fee-for-service models they have utilized over the course of their entire careers. Others struggle to see the benefits of value-based models and view them as pressure to do more with less, particularly with national data showing that fewer than 50% of ACOs received added compensation for participating in the new care models.

Further, some providers find it difficult processing how data analytics and social determinants of health can be incorporated into patient care, arguing:

  • "I don't have enough time to see patients, let alone resolve the psychosocial issues that are impacting health."
  • "How can I make holistic decisions about care when I don't have access to all of a patient's data?"
  • "I have sicker patients / more chronic illnesses than other physicians in my organization."

Population health management solutions ease these concerns. The cutting-edge platforms aggregate, normalize and analyze patient data, stratify risk, and allow providers to treat patients holistically – essentially, creating a framework for treating the right patients, the right way, at the right frequency.

With this in mind, what's the holdup?

We are learning that one of the biggest challenges for implementing value-based models is simply getting providers to the table. Physicians are busy people, and when you ask them to take the time to learn a new administrative process, they are often less than enthused. This can be easily addressed by designing incentives to ensure their participation.

Savvy leaders understand that time is money, and compensating physicians for attending meetings over the first six to 12 months of the plan is a simple technique for gaining their cooperation.

Over this period, show physicians how population health management works. Expose them to the analytical capabilities of cutting-edge applications designed to help, not hurt them. Let them visualize their highest-risk patient profiles and derive holistic treatment options based on individual needs. Incentivized and armed with their own metrics, a process begins where providers take greater interest in their own measures, which in turn leads to better performance over time.

This should be a period of self-realization as physicians may develop fresh perspectives on treatment by evaluating medical information presented in new and dynamic ways.

Leaders should emphasize that value-based care is the way of the future, and the only way practices will be able to survive is by driving value – through new systems that add data to the traditional reliance on memory and anecdotal information for patient care.

Over time, as physicians begin to see improvements in patient outcomes, they’ll also begin to see financial benefits through shared savings and MIPS bonuses.

Again, getting providers to the table is the hard part. But once physicians see population health management solutions in action, they will be more accepting of value-based care models.

Dr. Sanjay Seth

Blogger Name: Sanjay Seth

Date of Publishing : April 16, 2018

About the Author : Sanjay Seth, MD, is executive vice president at HealthEC. With over 30 years of clinical, administrative and consulting experience, Dr. Seth is uniquely positioned to develop population health management strategies that support health care providers and organizations.