Building Value in an Age of Value-Based Reimbursement

“What do you do when your core revenue model is disrupted?”

It’s a question healthcare industry decision-makers are struggling with every day. We’re in an age of “value-based” payment models stemming from factors such as passage of the ACA, a CMS focus on creating accountable care organizations (ACOs) and a long-running industry shift towards population health management. Payers are no longer reimbursing healthcare providers solely according to the number of procedures or visits conducted. Patient outcomes and quality evaluations now matter more than ever. 

Healthcare executives must adapt to this paradigm shift or risk diminishing reimbursement. No longer can the U.S. have the highest per capita healthcare costs but lag in patient outcomes. Everyone says that providing effective care is a priority, but now they have to prove it. Their income, after all, depends on it. 

Obvious process and technology changes must take place to help health systems align with value-based care models, but that’s only the start. To successfully adapt to new revenue standards, a deeper institutional shift will be required for many organizations to meet their goals moving forward. 

That’s where smart communications can help.

Make Your Mission Everyone’s Mission.
As the industry moves toward value-based payments, achieving the “triple aim” of patient experience improvement, population health improvement and cost control requires contributions from every member of a healthcare organization. As Dr. John Chessara, President and CEO of GBMC HealthCare System, put it in an interview with Becker’s Hospital Review, “If you get your people to adopt the mindset that it’s their right and duty to suggest ways to improve, they will have a greater sense of ownership over the change. Once in that mindset, they will start running with the ball and they will want to transform.” 

Making this sort of internal transformation requires a few steps. 

1. Think strategically about internal communications. Create an environment where everyone understands where the business is going, the leadership team’s vision for success and how each employee contributes to that vision. Then, develop a communications plans to foster alignment, engagement and subsequent action. Because as Dr. Howard Grant, President and CEO of Lahey Health, explains, “A committed workforce is far more likely to deliver the highest quality, most compassionate and most efficient care. And clear communication is a key driver to realize a high level of engagement.”

2. Encourage a patient-focused culture. If you are going to be evaluated based on providing care that keeps patients out of the emergency room and satisfied with your organization, every single employee must adopt that attitude. Make sure everyone understands that creating better patient outcomes and experiences is a core organizational value. Foster a culture program that reflects this belief, and don’t hesitate to reward and recognize employees living that mission—it’s how you create and nurture productive behaviors. 

3. Tell the world. Give your internal teams a greater sense that patient outcome-based values are truly important by reflecting that commitment in any external messaging. Reach out to community-based health groups, local publications, and patients directly to let them know that your organization’s main goal is improving population health and providing quality service. The commitment may be nothing new for your organization on paper, but it’s a chance to reinforce internal beliefs while reassuring potential patients that you have their best interests at heart. 

Business Challenges Have Communications Solutions.
It’s easy to look at some of the changes happening around reimbursement and feel like there’s little you can do about it. The meta trends sometimes simply feel too big to tackle. But what you can control are the communication strategies that equip your organization for success in this new reality we live in.

We’ve helped healthcare providers build internal communications plans that resonate with diverse audiences, showcase culture programs that drive engagement, and tell their stories in the public space before. We’re willing to bet we can help you, too. Contact me to talk through some ideas.

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