Value-Based Care In 2021

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Value-Based Care In
2021
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Value-Based Care In 2021
The healthcare industry is already facing
limitations of reliance on fee-for-service
reimbursement and COVID-19 pandemic exposed it
badly. Hence to overcome limitations of
fee-for-service model, Value-based care model has
emerged. Value-based care is a form of
reimbursement that ties payments for care
delivery to the quality of care provided and
rewards providers for both efficiency and
effectiveness. You can find various value-based
care models, such as the Medicare Shared Savings
Program and Pioneer Accountable Care Organization
(ACO) which transform how healthcare providers
are reimbursed for services rendered. President-e
lect Joe Biden is known for his advocacy of the
Affordable Care Act (ACA) that began the initial
push toward fee-for-value. But does value-based
care have any significance in 2021? Lets talk
about value-based Care in 2021 in more
details. Need for providers to lean into
value-based care During the COVID-19 pandemic,
heavy investment from providers in value-based
care are getting consistent source of revenue
despite low utilization. Dynamic regulatory
changes and innovations in care delivery offers
various revenue opportunities for providers by
increasing the portion of their business with
value-based care reimbursement. Moreover, the
continuous changes in health care which are
mainly driven by the pandemic are emphasizing
more on the need for providers to lean into
value-based care.
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Value-Based Care In 2021
Scope for innovation and disruption Commercial
payers are pushing towards innovative payment and
care models as COVID-19 has highlighted the
inequities in the healthcare delivery system and
challenges for providers. Moreover, The Biden
administrations health care goals are focused on
cost savings with quality care. This is fueling
the adoption of value-based care. Hence you can
observe that there is a drive from government and
private players to innovate various care delivery
models as well as payment systems due to
Covid-19. Telemedicine and other digital health
model Providers are offering their services via
telemedicine and other digital health care model
during the COVID-19 public health
emergency. According to research published in
Health Affairs, Early in the COVID-19 pandemic
telehealth visits accounted for approximately 30
of total outpatient visits and uptake varying
among specialties and by patient
characteristics. Providers opting a way for
digital health in the pandemic will have the
opportunity to capitalize on this investment as a
way to manage patient care and look for RoI for
services that are typically not reimbursable
under fee-for-service arrangements. Moreover,
many of the telehealth waivers have been made
permanent.
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Value-Based Care In 2021
Some programs like Hospital without Walls, Acute
Hospital Care at Home etc. which are created by
CMS to improve hospital capacity during
pandemic. Providers who invested in these
programs provide an opportunity for quality care
in lower cost environments which will benefit
fully engaged in value-based care
providers. Government initiatives for
value-based arrangements US government is now
focusing on value-based care by making some
changes in federal law to lower barriers to
value-based care. The Stark law and Anti-kickback
Statute created by CMS and the Office of
Inspector General (OIG) for value-based
arrangements allow providers to enter into
value-based care arrangements that previously may
have been prohibited. Moreover, patients and
providers are able to access health information,
further reducing structural barriers to
value-based care with the sweeping
interoperability and information blocking rules.
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Value-Based Care In 2021
For most healthcare providers value-based care is
still a new concept and many are still trying to
implement the appropriate systems into their
workflow. The transition from fee-for-service to
pay-for-value is the greatest financial
challenges the U.S. healthcare system currently
facing. Are you ready for this change? We are
expert Medical billing and coding professionals
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