By Whitney Chernoff, senior vice president for client engagement and growth operations, Vatica Health
Vatica Health recently conducted an independent survey of over 100 managers and executives of primary care practices and health systems to learn what’s working for them and what still needs to be addressed to facilitate a smooth transition to value-based care.
As senior vice president for client engagement and growth operations at Vatica, I routinely meet with physicians and provider group leaders working through this transition. I would like to share some observations based on my experience working with those on the front lines of this exciting and challenging industry-wide transformation.
1. Champions wanted
While the survey revealed that the majority of respondents believe that VBC will lead to improved patient outcomes, many practices lag behind in implementation. The number one reason? Lack of staff.
I can’t disagree with that; adding staff is certainly important. But a more important first step is finding a champion. Someone you can rely on to make sense of everything, keep up with changes and government regulations, identify the right initiatives to focus on, push your VBC initiatives forward, help you navigate around roadblocks, assess the financial impact and measure success.
Ideally, this person should come from within your organization. Their knowledge of your people and processes will be invaluable when determining how best to navigate moving along the VBC continuum. Also, in today’s healthcare labor market, it can be difficult to find and hire outside experts. Once you find your champion, resources such as Vatica can provide them with expert support at no cost to your organization.
2. The time is now
CMS has a goal for 100% of Original Medicare beneficiaries to be in a care relationship with a VBC payment model by 2030. In addition, CMS recently announced the gradual transition to version 28 (V28) of the CMS-HCC model, which will be phased in and fully implemented by 2025. The changes from transitioning to the V28 model will make it more challenging to produce highly compliant revenue via risk adjustment. This could lead to a negative impact on your financial performance in the absence of a comprehensive, well-managed solution. While these new regulatory changes take hold, it is important for health plans to offer the right solutions to allow PCPs to continue or begin their transition to VBC. The sooner you begin, the sooner you can gain the advantages of VBC: improved patient care, reduced cost of care and better care coordination.
3. Turnovers: bad for football, worse for your practice
Caregiver turnover is a very real problem across the industry. And that’s especially the case with PCPs. Losing physicians means losing expertise and—potentially—patients. It can also mean losing continuity and creating greater strain for the PCPs who remain in place. Success in a VBC world means practices should do whatever they can to retain their most important and experienced staff. Like what?
- Implement strategies, policies or technologies that can improve everyone’s work-life balance. Carving out time for administrative tasks, which are often a necessary evil, can help ensure everyone works more efficiently and gets home at a reasonable hour.
- Explore ways to improve compensation models and incentive programs so more staff have a stake in the overall success of the organization.
- Provide pathways for continuing education. This not only engages employees; it also ensures your organization can grow and keep up with changes.
By preventing brain drain, you reduce the cost of recruitment, onboarding and lost productivity and help ensure any VBC initiatives you implement will survive, evolve and thrive.
4. Inertia is enemy #1
One of the most common things I hear from providers is, “I’m too overwhelmed to think about how to not be overwhelmed.” But transitioning to VBC payment models can result in so many dividends for you and your patients; you HAVE to find the time. I understand how busy we all are. But if you can find a little time each week to meet with staff and outline a plan to move forward, you’ll find it gets easier—and more profitable. Consider outside resources to help. A vendor such as Vatica can reduce the administrative burden of coding and documentation for your providers while identifying open care gaps and ensuring accuracy and compliance. If you select the right resources, you can speed your time to adoption and get some time back in your day for yourself and everyone else at your practice.
