Core Solutions Blog

The 3 Steps for Success in a Value-Based Environment


Value-based payment (VBP) is a strategy that more and more payers and health care providers are adopting. Under the VBP model, volume-based methodology and practices are eschewed in favor of overall value through savings and improved outcomes. However, implementing this system requires a fully optimized revenue cycle that serves as the foundation for the worth that VBP provides. This means the links between encounter reporting, scheduling systems, and billing systems need to be consolidated.

The right combination of people, processes, and technology is required to increase the efficiency of each of these core links. Centralizing your internal processes and revenue cycle operations will bring about the improved consumer experiences and reduced costs that value-based environments are based upon. Take a look at the three areas you should optimize in order to integrate or better adjust your scheduling and billing processes to increase overall value.

  1. Eliminating Inefficiencies
    Operate on lean healthcare concepts and apply these principles to simplify your scheduling. Lean organizations generate more value for consumers through the use of fewer resources and all of their systems are based around this goal. Target your consumer value, recognize the appropriate steps that lead to value, and allow the stream to operate on timelines that directly follow the consumer’s journey. Eliminating waste is a large part of keeping a lean focus; start by avoiding unnecessary steps and overproduction, managing inventory waste, and keeping employees engaged by listening to their needs and providing support. Utilizing lean concepts will help create centralized scheduling processes and maximize the use of resources and services for your consumers.
  1. Becoming Data-Driven
    It’s no secret that we’re proponents of a data-driven organization. Value-based systems require a strong data-driven approach to serve as the foundation for refined and overall improved practices. To form a data culture, democratize your data, provide more data tools, and make numbers more widely available in order to share the knowledge that influences key decisions. Invest in data literacy and analytics and embrace continuous A/B testing; tie these results to your strategies and make data a constant priority to preserve your data culture.
  1. Rethinking Revenue Cycle
    A centralized revenue cycle management system (RCM) is another vital element in successful value-based environments and should become integrated with the entire end-to-end care process. In a VBP revenue cycle, performance monitoring occurs after sending out bills, and customer experience and outcomes are observed throughout the cycle. Throughout the transition to a centralized RCM however, the cycle should be adaptable to both traditional fee-for-service systems and rising fee-for-value systems as well. To optimize your RCM, practice upfront validations and population thinking, correct missed opportunities for care, and work to further simplify your consumers’ bills.

 Keeping these three tactics in mind will help you to succeed in value-based environments by maintaining a focus on each element of the VBP Triple Aim: better care, improved patient satisfaction, and reduced costs. Focus your efforts on optimizing your revenue cycle in order to meet your value-based goals and reap the full benefits of this strategy.

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