Welcome to the Patient-Centered Care Revolution

Posted on 22 Aug, 2017 |comments_icon 0|By Elizabeth
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Make no mistake—there is a lot of uncertainty swirling around healthcare. But one thing you can count on is a transition from “fee-for-service” reimbursement to value-based reimbursement.

Federal and private payers are no longer content to reimburse providers simply for the number of procedures they perform. They are measuring outcomes to assess and pay for provider performance, and patient engagement heavily influences outcomes.

A patient-centered approach has never been more crucial to your practice’s financial health.

High-Deductible Health Plans Raise the Stakes Even More

Potentially the biggest factor driving the patient-centered care movement is that patients themselves are paying more out of their pockets for healthcare than ever before.

A 2016 National Center for Health Statistics (NCHS) report shows that 40 percent of privately insured people under 65 are enrolled in high-deductible health plans (HDHPs) and are subject to a maximum amount out-of-pocket limit at $6,550 for self-only coverage—$13,100 for self-and-family.

The Value-Based Care Upheaval

Nothing, though, has made the patient experience more important in healthcare than the shift from fee-for-service to value-based care. Value-based legislation—MACRA, 21st Century Cures, HITECH—espouse the idea of payers reimbursing providers based on how well they improve their patients’ health outcomes, as opposed to the number of procedures they perform.

Payers now rely on customer satisfaction measures to evaluate provider performance. This shift in healthcare has made it crucial for providers to invest time, money, and energy in creating a positive experience for their patients in their practice.

The 6 Principles of Person-centered Care

Recently, the Healthcare Transformation Task Force, a group of providers, insurers, employers, and patient advocates, laid out the 6 principles of person-centered care and value-based payment:

  1. Include patients as partners in decision-making at all levels of care. Among other things, providers should provide systems that allow them to see patient-generated data and patient-reported outcome measures. Providers should create a culture that emphasizes shared decision-making, and they should support that culture with digital tools.
  2. Deliver person-centered care. One big requirement of person-centered care is “safe, seamless, and person-centered transitions across providers and care settings,” the Task Force notes. We are far from this ideal, and it requires EHR systems that are interoperable.
  3. Design alternative payment models (APMs) that benefit consumers. Benefits include “better care, better quality, improved patient experience, [and] lower patient cost,” the Task Force notes.
  4. Drive continuous quality improvement. Give patients and their caregivers access to quality ratings, the Task Force urges. Incorporate patient feedback into quality measures.
  5. Accelerate use of person-centered health information technology. HIT should put “the consumer at the center of accessing, managing, and sharing their electronic health information whenever they receive care,” the Task Force says. Privacy and security are safeguarded, and digital tools such as portals, apps, and telemedicine systems are easy to use.
  6. Promote health equity for all. 

As patients approach their healthcare as consumers, shopping for and comparing providers, medical practices must adapt by creating high-quality patient experiences to attract and retain patients long-term. 

For time- and cost-efficient methods to safeguard your practice’s financial health through effective patient engagement, pick up Ready, Set, Engage: How to Create a Patient-Centered Practice.

Reference:

Ness, Debra, David Lansky, Richard Gilfillan, Fran Soistman, and Jay Cohen (August 30, 2016). How Person-Centered Is Your Health Care Organization? HealthAffairs Blog

How Person-Centered Is Your Health Care Organization?

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