Regardless of what happens with the Affordable Care Act, a shift to value-based reimbursement appears to be ahead based on a wide variety of industry musings and predictions. MACRA, Alternative Payment Models and other quality reporting programs that affect levels of payment, are here to stay. And all healthcare provider organizations need to be prepared for the impact.
Many aspects of business and operational processes must be evaluated and adjusted. The shift to value involves major changes for all affected stakeholders, requiring a strategic plan to manage the transition. Here are ten parts of this work that you may need to consider:
1. IT review and strategy
2. Data harmonization
3. Interoperability and new clinical system deployments
4. Analytics and population health
5. EHR optimization
6. Revenue cycle improvement
7. Cost accounting approaches
8. Alternative payment models
9. Clinical documentation and coding
10. Clinical quality reporting
Pivot Point’s recent info brief on value-based care describes these ten challenges in more detail and outlines specific changes for your organization’s top-five operational areas: administrative process, financial management, patient care, revenue cycle and IT systems.
Our healthcare advisors and IT consultants already support dozens of health systems nationwide in the journey to value-based care. And we’re ready to help your organization prepare too!
Jon Melling is a management consultant with over 30 years’ experience working in health informatics in the United States and internationally. He is a leading authority in revenue cycle, health information exchange and interoperability strategy. He is the past chair of the Health Business Solutions Committee, served as a member of the ICD-10 Task Force and currently is a member of the HIMSS Revenue Cycle Improvement Task Force and the Alternative Payment Methods Task Force.
To learn more about strategic consulting services to assist your move to value-based reimbursement, contact us at info@pivotpointconsulting or 800.381.9681.