Is value-based pay leading to more MD face time?
In the fee-for-service world, physicians need to squeeze in more visits into less time. Here’s how value-based reimbursement is changing the model.
Is value-based reimbursement helping physicians spend more time with patients? If you ask Farzad Mostashari, CEO at Aledade, a Bethesda, Maryland-based accountable care organization (ACO) services company, the short answer is yes.
In the fee-for-service world, physicians need to squeeze more visits into less time to experience a revenue increase. By way of contrast, in the value-based care model, providers have a set amount of money allotted to take care of each patient, and can then choose how to invest that money. As a result, it makes much more sense not to send patients to different specialists-at least not until the primary-care physician can spend more time with the patient to determine their health status, says Mostashari, who previously served as the U.S. National Coordinator of Health Information Technology.
In an outcome-based payment system, it also makes sense for primary-care doctors to spend more time with their sicker, more complicated patients, to prevent avoidable complications, unnecessary emergency room visits, and preventable hospitalizations, says Mostashari.
In the ACOs with which Aledade works, doctors are spending more time with their patients, especially those at highest risk. For example, patients are being called within 48 hours of discharge from the hospital to see how they are doing back at home. In addition, patients’ medication lists are reviewed, and they are seen in person by their primary-care physicians, he says. “We have found that these extra visits and attention are not only good for the patients, but they also save the system money: reducing readmissions in the highest risk group from 33% to 20%.”
While value-based reimbursement has perks for physicians, healthcare executives must keep in mind that the transition to value-based care is also going to be painful, says David Muhlestein, senior director of research and development at Salt Lake City, Utah-based-based Leavitt Partners. “Learning new skills and performing similar services but in a new way is not easy,” he says.
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