Journal of Healthcare Management - March/April 2016 - (Page 90)

V A L U E - B A S E D C A R E Improving Care Across the Continuum Tawnya Bosko, DHA, vice president, population health practice, GE Healthcare Camden Group, Los Angeles, California, and Bridget Gulotta, RN, senior consultant, population health practice, GE Healthcare Camden Group A s the healthcare landscape shifts from volume-based reimbursement to valuebased care, organizations need to develop innovative strategies for managing risk and avoiding penalties. Moving to true value-based care and long-term sustainability requires a systemic shift in the approach to care delivery across the continuum. We address several important questions about improving care across the continuum. What methods can be used to engage physicians and provider networks to address care across the continuum? As new payment models reward and penalize organizations for the quality of care provided, a corresponding need arises to transition physician compensation models from a focus on production (relative value units) to a focus on value. Contracts need to clearly define the organization's strategy and goals, as well as the expectations and accountabilities of the contracted providers. The design of compensation models should align organizational and system goals with physician goals; identify appropriate quality benchmarks; determine the proportion of compensation at risk; and incorporate productivity, quality and outcomes, patient satisfaction, and panel size. Reporting on quality measures may be familiar to providers who have participated in pay-for-performance programs such as the Physician Quality Reporting System, the Hospital Inpatient Quality Reporting Program, and the Hospital Outpatient Quality Reporting Program. To promote appropriate and accountable care, value-based model metrics are now tied to incentives and penalties for providers, who must prove they are not only reducing the overall cost of care delivered but also meeting quality standards. As payers continue to expand patient populations required for reporting financial and quality metrics, effective management and alignment of contract incentives are needed to ensure the efficient delivery of care and improved quality of care. Additionally, as the care delivery model for primary care physicians (PCPs) continues to move toward patient-centered models by organizing as a medical home or medical neighborhood, compensation models need to promote health outcomes and the coordination of care team members across the continuum. PCPs are tasked with driving care via a proactive, collaborative approach with patients and specialists and a focus on chronic disease management. New models of care will improve the health of populations and add value for patients, and compensation plans need to support the evolution of care delivery. 90

Table of Contents for the Digital Edition of Journal of Healthcare Management - March/April 2016

Journal of Healthcare Management - March/April 2016
Contents
Interview With Peter S. Fine, FACHE, President and CEO of Banner Health
Reducing Physician Burnout Through Engagement
Improving Care Across the Continuum
Analysis of the Community Benefit Standard in Texas Hospitals
Physician–Organization Collaboration Reduces Physician Burnout and Promotes Engagement: The Mayo Clinic Experience
Work–Family Conflict Among Newly Licensed Registered Nurses: A Structural Equation Model of Antecedents and Outcomes
Hospital Systems, Convenient Care Strategies, and Healthcare Reform

Journal of Healthcare Management - March/April 2016