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9 Reasons You Should Try Value-based Payment

Successful family physicians give the top nine reasons why you should implement value-based payment in your practice and make primary care the cornerstone of all care.

Reason 1. It works.

“I figured it was going to be kind of like everything else we had done up to that point, but even a few months into it, I was like, ‘This really is better care. And this really could benefit us.’ We got data back that one patient had been to the ER more than 40 times in the year before, and it was always on a weekend. My care manager started calling him every Friday morning to ask, ‘Do you need to be seen? Do you need any refills?’ And like that, the following year, he went to the ER maybe twice.”

Independent physician | Rural practice

“I have had a number of success stories come from learning about a patient with more depth and being able to manage their care or help their caregiver or offer some advice on what to do when such-and-such happens. That has led to better care and lower costs. I’m able to intervene earlier upstream.”

Employed physician | Urban academic practice

“We’ve seen tremendous decrease in just percentages of readmissions. I think if you look at the hospital system in general, it might be in the 21-25% readmissions and we’ve been able to drive down to about 11%, sometimes lower. That has been remarkable change that’s kept patients out of the hospital—and saved tremendous amounts of money on the other end.”

Employed physician | Group practice

Reason 2. It’s a better way to work.

“It’s work that’s worth it because patients are so happy, and it’s good care. I would say it’s more work that you don’t mind doing. It’s not mindless, it’s not menial, it’s not frustrating. It’s actually work that’s in line with good care. It makes me happy. It’s exactly the kind of care I imagine being able to deliver. There’s no part of that that makes me not satisfied.”

Independent physician | Urban practice

“This is sustainable, and it brings joy. And so sustainable joy is a good thing.”

Independent physician | Rural practice

“You become more efficient in terms of what you’re doing. It’s not so much an add-on as opposed to adopting effective ways of taking care of your patients.”

Independent physician | Rural practice

“It feels more empowering for us to be more proactive with our patients rather than waiting for them to come in. It’s the right kind of work that we want to be doing.”

Independent physician | Rural practice

Reason 3. Patients love it.

“Patients rave about the care management program. When I discuss it with a patient, I say to them, ‘You are a VIP and I am very worried about you, and I need to stay closer to you than I am currently.’”

Independent physician | Urban practice

“Our patients love our care management. My care manager calls them, like, once a week and just checks in. She becomes such an important part of their care.”

Independent physician | Rural practice

“Taking time to solve problems for a patient increases trust. Patients say, ‘I know my doctor cares enough about me to make a change …’ That is why I think those of us in family medicine are so well received in our communities, because our patients trust that we’re going to go the extra mile, we’re going to take a chance because it’s for them. And that makes me feel good.”

Independent physician | Rural practice

Reason 4. It makes primary care the cornerstone.

“In a value-based system, primary care is at the top. It has not been that way. If you’re hesitant to join the effort to make primary care the cornerstone, this is the way to be noticed. This is the time to take the risk on behalf of the specialty. I’m pretty optimistic about it.”

Employed physician | Urban academic practice

“I think in order to fight all the good fights of the runaway health care system—quality of life, burnout, workforce issues—this is the answer to all of those things.”

Independent physician | Urban practice

Reason 5. It’s not one-size-fits all, so start where you are.

“Engage. I always tell people, ‘Understand what value-based care looks like, and pick one thing that you can do different.’ Pick a hospital that your patients go to and partner with them and start learning how to do transitional care management services and start doing them. It can be anything.”

Independent physician | Rural practice

“The way we thought of trying value-based care with a private payer was, ‘Why not? We’re already providing this better care for our Medicare patients, why wouldn’t we do similar things for commercially insured patients as well?’ Bringing value-based care to more patients, building on the work we’d already done, made things easier because we could just streamline our workflow.”

Independent physician | Rural practice

Reason 6. It brings people and partners together for patients.

“When you see that you have a host of colleagues, that you have an academy in your state and nationally, and they’re all working for you and your patient, that gives you a sense of, ‘OK, I can do this.’”

Independent physician | Rural practice

“My partners and I are fiercely independent. We chose a physician-led ACO that only represents independent practices. With them, I am not thinking about contracts. I just take care of patients.”

Independent physician | Urban practice

Reason 7. It’s rewarding for the whole team.

“It allows all of us within the practice to work at our comfort level, our license level, and our training level. It provides the flexibility to match responsibilities with staff skill sets. I’m not the best person to ask a patient to take their medicine. But my R.N. coordinator, I don't know ... she says something different, they take their medicine.”

Independent physician | Rural practice

“Our workforce retention is remarkable because of value-based care. Fee-for-service was not what we are relying on in order to bonus our staff or really give raises ... we actually bonus them when we make shared savings in the fall and at the end of the year for performance, so they know that this is not just a generic bonus, this is their value-based care bonus.”

Independent physician | Urban practice

Reason 8. It drives revenue that can save—even grow—your practice.

“The amount we get could pay for one of our physicians now. Over the course of the pandemic, when we weren’t seeing as many people, it helped us to be able to stay open and be able to pay ourselves normal wages. It really has been significant enough to grow our practice. It was scary at first, but it has paid off.”

Independent physician | Rural practice

“When COVID hit ... we had no money ... one of our payers said, ‘Look, we will advance the shared savings check to you.’ That shared savings check that they advanced ... saved our practice. But had we not been part of a shared savings program the year before, there would have been no money to come in.”

Independent physician | Rural practice

Reason 9. It ensures you’re accurately paid and properly funded.

“For every $1 we invested into two care managers, we got back $4.10, and that did not include shared savings. Care management ramped up our annual wellness visits. It helped us ramp up our transitional care management, do things that we were trained to do. The best thing that chronic care management gave us was this wonderful, soul-satisfying ability to help take care of your patients outside the practice walls.”

Independent physician | Rural practice

“From the very first month that we saw the codes being submitted and accepted and paid, we realized that this was care we had been delivering without reimbursement prior to this.”

Independent physician | Urban practice

Getting Started: Your 3 Next Steps

Learn what simple steps you can take to set you on the path to value-based payment.

READ GETTING STARTED TIPS

9 Reasons You Should Try Value-based Payment

Getting Started: Your 3 Next Steps

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