Many health care providers today receive a payment for each individual service they provide such as a physician visit, surgery, or blood test, and it matters to a lesser extent today whether these services directly improve the patient’s outcome. In other words, providers are paid primarily based on the volume of care they provide, rather than the value of care provided to patients. Emerging value-based reimbursement models increasingly require providers to prove that they’re meeting quality standards and benefitting patients while cutting costs. As a result, providers need actionable information to help them continually measure, monitor, and improve financial and quality performance. Furthermore, if they aren’t on track to meet quality standards, they need to be able to pinpoint root causes: Does performance differ by facility? Which providers are performing best and what can be learned from them?

To thrive in a value-based environment, health systems must develop the sophistication to understand their quality and cost structure in granular detail. Reducing every category of waste — e.g. waste that occurs when work isn’t standardized, waste that stems from unnecessary orders, waste that results from uncoordinated patient care — are all absolutely essential for improving margins.

Do these concepts seem familiar to you as a quality practitioner? If so, join us for a discussion of how quality professionals can support the transition to a value based reimbursement model in healthcare.
Continue reading September 2015 Meeting – The role of quality in the transition to Value Based Reimbursement in Healthcare →