Your hospital — unless it’s still holding on dearly to the old way of doing business — is about to enter murky and unchartered waters. But those efforts are at risk of sinking before you even leave the dock if you don’t have the proper tools to make the journey.
All across the health care landscape, we’re seeing signs that hospitals and insurers are finally making the transition to a value-based model of care that rewards quality and outcomes rather than just the number of visits. Earlier this year, Health & Human Services made a big splash when it announced that 50 percent of Medicare payments would be tied to such value-based reimbursement by 2018. Others, such as the University of Vermont Medical Center, have followed the feds' lead in recent months.
Making the switch, however, requires a whole new set of tools and capabilities, such as determining the true cost of providing care, as the University of Utah Health Care has found. Hoping to help providers gauge their readiness for such value-based care, the Healthcare Information and Management Systems Society recently released a survey on the topic. With it, hospitals and health system leaders can ask themselves a series of questions to see where they stand.
“We need to begin thinking about how the industry can support providers in making the transition to value-based payment in a meaningful and widespread way,” Pamela Jodock, a senior director with HIMSS, said in a press release. “From a health IT perspective, what infrastructure do we need to have in place for a successful transition? The survey is intended to help us start that conversation.”
The survey, available through the end of this month, is broken into five parts: demographics, the cost of health care, pricing, fee-for-service vs. value-based purchasing, and transparency. It asks providers to peg their own readiness for the changeover to a new model of care, and helps to determine what pieces might be missing from their toolbox.
In this increasingly retaillike health care environment, the ability to say exactly what an episode of care costs will be crucial, HIMSS notes, requiring tools to both assess costs and manage the revenue cycle. It’s time that providers pull back the curtain on the actual cost of providing care, Jodock said in the release. “Today, the cost listed in a chargemaster is less a reflection of what it costs the hospital to deliver the related service and more a reflection of the price private health insurance companies are willing to pay.”
As I mentioned earlier, the University of Vermont Medical Center is one organization already making the move. Its CEO, John Brumsted, M.D., last month announced ambitious plans to link 80 percent of payments to quality of care by 2018, exceeding federal timeline targets. In a press release, he said it will be challenging, but he believes change is overdue.
"It is long past time for health care providers across the nation to center everything we do on achieving optimal health for our patients and provide them with an efficient and pleasant experience,” Brumsted said. “It is simply the right thing to do, and the best way to reform our expensive and underperforming health care system."
HIMSS plans to release the results from its survey at its annual conference Feb. 29 to March 4 in Las Vegas.