Value-Based Payments Demystified: Key Metrics Every Provider Should Track

Managing healthcare costs can be challenging. With so many factors to keep track of, it is easy for healthcare providers to lose focus.

Value-based care models change the way that healthcare providers are reimbursed. Providers may receive shared savings, bundled payments, or global capitation based on quality and cost targets.

Value-based reimbursement creates more opportunities to increase patient satisfaction, lower costs, and improve outcomes. Learn more about this game-changing model and its benefits for patients and providers.

Patient Satisfaction

Value-based payments (VBP) incentivize providers to improve outcomes and reduce costs. This shift from fee-for-service models allows healthcare organizations to avoid costly procedures that may not be medically necessary or result in positive effects while ensuring patients receive high-quality care. Understanding and tracking quality metrics in healthcare is essential for providers participating in value-based payments, as these metrics serve as crucial indicators of care effectiveness and patient outcomes, guiding providers toward delivering high-quality care.

Patients are aware of the cost of their healthcare and want to be treated like valued customers, so keeping up with patient satisfaction trends is essential. Physicians and nurses who can establish a personal connection with their patients and communicate clearly and compassionately are more likely to build trust and boost overall satisfaction scores.

One popular way to measure patient satisfaction is through Net Promoter Score (NPS), which asks patients a simple question about whether they would recommend their provider to others. This can be done in person, via phone, or through email surveys.

Patient Engagement

Patient engagement is a common buzzword in healthcare but is often difficult to understand. The concept is multifaceted and has many components, including engaging patients with their care, behaviors influencing engagement, and outcomes.

To maximize patient engagement, a healthcare organization must deploy strategies addressing these factors. To do so, they must leverage technologies such as electronic health records (EHRs) and healthcare customer relationship management (CRM) systems that facilitate the gathering and analysis of data.

Once this data is collected, a healthcare organization can efficiently use marketing automation tools to reach patients with relevant nudges and education materials. For example, appointment reminders, medication adherence nudges, and prescription refill notifications are good candidates for automated messaging.

Value-Based Payments Demystified: Key Metrics Every Provider Should Track

Patient Safety

Despite the best efforts of healthcare workers in top-notch clinical facilities, accidents or misdiagnoses can still occur. Medication errors, for example, cost $42 billion a year.

Patient safety seeks to create a culture of trustworthiness under conditions of risk. It does so by preventing avoidable adverse events, providing clear and accessible procedures, encouraging everyone to report near misses and adverse events, and learning from them. Moreover, healthcare metrics are pivotal in value-based payments, guiding providers to monitor and optimize critical indicators, ultimately enhancing patient care quality and outcomes while aligning with payment incentives.

It also rejects the traditions of guilds in which social standing and privileged knowledge shielded practitioners from accountability while embracing responsibility and accountability for personal and organizational actions. Moreover, it applies methods from various disciplines: engineering, psychology, sociology, human factors, anthropometry, and health services research. It also seeks to understand what makes some methodologies more practical, such as root cause analysis.

Patient Outcomes

Patient outcomes are a crucial measure of value-based payments in the healthcare industry. While the concept is relatively new, this model of reimbursement promises to improve outcomes and reduce costs.

Outcomes are defined as changes in a patient’s health condition that can be linked to previous healthcare treatment. They can be measured using various tools, including patient-reported outcomes measures or PROMs.

These measures ask patients to answer questions about their overall well-being and quality of life, such as their pain level or ability to complete daily activities. These results are then used to compare the effectiveness of various treatments and procedures. This data helps providers identify areas where they can improve care delivery while showing payers that their investments in patient outcomes are paying off.

Patient Experience

For providers, value-based payments shift the emphasis from volume to quality. Reimbursement is based on the outcome of patient care and can involve shared savings, global capitation, bundled payment, or risk-sharing.

Payers are increasing their focus on racial disparities and aligning their value-based programs with the needs of their patients. The COVID-19 pandemic has highlighted the need for more granular data on how payers’ value-based models are affecting patients, especially in low-income and minority communities.

Unlike satisfaction, which only assesses how well something happened, patient experience encompasses an individual’s entire journey through the healthcare system. World-class patient experience programs use quantitative surveys and qualitative focus to determine how well healthcare providers meet patients’ needs before, during, and after care delivery. This is an essential component of patient-centered care.

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About Dequiana Jackson

Dequiana Jackson, Founder of Inspired Marketing, Inc., helps overachieving women entrepreneurs conquer limiting beliefs and create marketing plans that grow their businesses. This includes one-on-one marketing plan development, digital product creation, web design and content marketing. Dequiana is the author of Know Your Business: How to Attract Ideal Clients & Sell More and runs the award-winning blog, Entrepreneur-Resources.net.

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