Value-based care is becoming more prevalent across US health systems - but it comes with some headaches

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Value-based care is becoming more prevalent across US health systems - but it comes with some headaches
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Efforts to implement value-based care (VBC) programs have snowballed: Forty-eight states and territories in the US currently implement VBC programs, compared to just three in 2011, per new research conducted by US health IT firm Change Healthcare.

The Number of US States and Territories Implementing VBC Programs Has Spiked in Recent Years

For context, VBC models tie hospital payment to the quality of care provided as opposed to the number of services provided. And while VBC models offer clear benefits to insurers and employers since they encourage lower medical costs and better outcomes, the outlook is less rosy for providers.

Here's what it means: As VBC becomes more prevalent across health systems, navigating the model's murky waters can be onerous for providers.

  • Physicians are faced with a heavy clerical burden while trying to comply with the regulatory requirements of VBC payments. Ninety percent of providers say Medicare and Medicaid's pivot to VBC has escalated their regulatory burden, and nearly 80% say the shift to VBC hasn't been successful. That's likely because VBC forces providers to spend more time meeting data reporting standards and dealing with billing complexities.
  • And providers have to get savvier about managing patient readmissions - or pay hefty penalties. Hospital readmission penalties are a hallmark of the US government's push toward VBC, and the Centers for Medicare and Medicaid Services has imposed nearly $2 billion in penalties on hospitals with "higher-than-expected" 30-day readmission rates since 2012.

The bigger picture: Providers can turn to tech solutions to help streamline the transition to VBC models.

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  • AI-powered voice assistants can help providers automate administrative inefficiencies imposed by VBC. Voice tech has proven it could help providers lighten the load of ballooning administrative duties: For example, physicians using voice assistant Suki cut the time spent on taking medical notes by 70%.
  • Providers can invest in care coordination IT to help streamline patient management and reduce readmission penalties. Care coordination IT (CCIT) refers to technology used to transfer patient information across the care continuum. It could help providers reduce readmissions by putting a dent in the 80% of medical errors that arise because of inadequate communication during care transitions. Moreover, CCIT could help providers avoid being left on the hook for wasteful treatments and spending stemming from misdiagnoses.

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