Don't Be Late to the Party: Importance of Adopting a Value-Based Care Model

Published in Respiratory & Sleep on April 04, 2023

Boone LockardBy Boone Lockard, Director, VGM Respiratory 

Value-based care is a popular term in the HME industry, especially in recent years. As the industry shifts towards a more value-based approach, it’s important for providers to understand its significance and why they should start to incorporate value-based care programs into their business sooner rather than later. 

What is Value-Based Care? 

The value-based care model is a healthcare delivery approach that emphasizes achieving optimal health outcomes for patients at a lower cost. Rather than focusing solely on the volume of care provided, value-based care prioritizes patient outcomes and quality of care while also trying to control costs. 

Under a value-based care model, healthcare providers are incentivized to deliver high-quality care that leads to positive health outcomes, improves patient health, reduces readmissions costs, and ultimately lowers healthcare costs. This model aims to shift away from a short-term focus on payment methods to a more long-term model that generates substantial savings and also improves quality. 

Currently, we see that many DME providers are trying to adopt a value-based care model into their businesses, whether it be by implementing clinical sessions, providing a plan of care goals to their patients, etc. The key to this, however, is to capture the data that is being collected and utilize it in a tool or platform to demonstrate the effectiveness of their programs. Being able to go to payers and physicians with this data to show what these programs are actually doing for their patients and how they are improving metrics is huge. 

We are also seeing that while providers are supplying the equipment, doing the setup, providing education regarding that setup, and so on, they're really focused on compliance. However, under a value-based care model, it is important to think of the patient as a whole, in regard to their overall condition or disease state, rather than just providing a piece of equipment or a fee-for-service type model. Aim to manage patients, not just the compliance aspect. 

Value-Based is Here to Stay 

The shift towards a value-based care model has gained momentum across the country, with many healthcare providers and organizations adopting this approach to healthcare delivery. The Centers for Medicare & Medicaid Services (CMS) has proposed that by 2030, 100% of their patients will be moved over to a value or outcomes-based reimbursement structure. The idea of this is for CMS to move away from a short-term focus on payment methods to a more long-term model that generates substantial savings and also improves quality. 

DME providers should start considering how to shift their current structure to reflect a more value-based care model. Providers that have already adopted this model will likely stand out to payers and referral sources over a provider still utilizing a fee-for-service model. 

Programs to Deliver Outcomes 

There are a number of programs and services in the industry that can help providers start moving towards a value-based model that can also help capture more referrals and patients in the long run. 

There are certain programs out there that take the care plans and models, along with the metrics and data gathered, and provide them into a deliverable software platform, making it easy to deliver those outcomes and data to physicians and payer sources. 

While the direct impact on revenue may not be immediate, there could be potential cost savings for providers in the long term as value-based care models focus on reducing hospital readmissions and improving patient outcomes, which can ultimately result in lower costs. Additionally, providers may be eligible for incentives or bonuses for meeting certain quality metrics or outcomes, which can also positively impact their revenue. Plus, providers are more likely to win over referral sources or providers with a value-based care model. 

Overall, the shift towards value-based care can have long term benefits for both patients and providers. 


TAGS

  1. hme
  2. respiratory
  3. vgm

From Our Experts

Fisher & Paykel Healthcare Launches New Selection and Sizing Tools in the F&P myMask™ App thumbnail Fisher & Paykel Healthcare Launches New Selection and Sizing Tools in the F&P myMask™ App The updated F&P myMask App* now offers mask selection and sizing in addition to the existing step-by-step education and support video content. VGM & Associates Announces Boone Lockard as VP, Clinical Services thumbnail VGM & Associates Announces Boone Lockard as VP, Clinical Services VGM & Associates is excited to announce that Boone Lockard, CRT, has been promoted to VP of Clinical Services. The Case for Outsourcing CPAP Resupply Order Fulfillment thumbnail The Case for Outsourcing CPAP Resupply Order Fulfillment From cost savings to technological integration, there are a number of compelling reasons why outsourcing CPAP resupply order fulfillment can be a game-changing solution for providers. Breathing Life into Healthcare - Celebrating Respiratory Care Week thumbnail Breathing Life into Healthcare - Celebrating Respiratory Care Week Respiratory Care Week takes place Oct. 22-28, 2023, and the focus shifts to bringing attention to the invaluable contributions of respiratory therapists (RTs) and specialists. Boost Efficiency and Preserve Assets: Streamlining Repairs with Outsourcing and Tracking thumbnail Boost Efficiency and Preserve Assets: Streamlining Repairs with Outsourcing and Tracking Your business can alleviate the burden of maintenance and repairs on respiratory equipment and also substantially reduce the loss of high value assets each year through outsourcing. Partnership for Positive Outcomes with MedSouth and Encore thumbnail Partnership for Positive Outcomes with MedSouth and Encore Boone Lockard, Director of VGM Respiratory, talks with Encore Healthcare and MedSouth Inc. about their partnership and the positive outcomes MedSouth Inc. has seen using Encore's Nexus Software and Program. Breathing Easy at Home: Exploring the Opportunities and Challenges of Home Mechanical Ventilation thumbnail Breathing Easy at Home: Exploring the Opportunities and Challenges of Home Mechanical Ventilation Home mechanical ventilation (HMV) has revolutionized the way respiratory care is delivered, enabling patients to receive vital support in the comfort of their own homes. Sleep Therapy Market: Keeping Calm and Carrying On thumbnail Sleep Therapy Market: Keeping Calm and Carrying On Originally featured in HME News, Boone Lockard, director of VGM Respiratory, weighs in on what he's currently seeing in the sleep market.