MedicalGPS, LLC

Understanding Value Based Healthcare

Posted by Jerry Stone on Oct 4, 2016 1:14:38 PM

value based healthcareThe current fee-for-service payment model is out and value based care is here to stay.  So what exactly is value based care?  Although there is not one standardized definition, value based care can be described as improving quality, efficiency, and outcomes in patient care. A value based care approach is one that is designed around the patient and focused on delivering value as opposed to volume.

What is Value Based Purchasing?

Value based purchasing is the measurement, reporting, and reimbursement of healthcare based on performance, quality, and excellence. Simply put value based purchasing rewards providers and organizations for good performance and penalizes them for poor performance. 

Why is Value Based Purchasing Important?

It is commonly known that The US spends more on healthcare than most other developed countries yet it consistently performs worse in comparison. The cost of providing healthcare to an average American family has surpassed $25,000 for the first time in 2016. According to The Organization for Economic Co-operation and Development (OECD), United States spends 16.4 percent of GDP on healthcare, which is almost twice the OECD average of 8.9 percent. Yet, when comparing quality, efficiency, access and health outcomes the US has ranked last in relation to 10 other developed nations including (Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom).

A report from the National Research Council and Institute of Medicine reviewed health compared to 16 other developed countries and discovered that the US consistently ranked poorly on almost every measure. Below are some of the findings:

• Highest death rate in women due to complications with pregnancy and childbirth

• Highest rate of death in children before the age of 5

• Second-highest death rate due to heart disease

• Second-highest death rate from lung disease

• Some of the highest rates of cardiovascular disease, lung disease, obesity, and diabetes

Healthcare in the US has been far too expensive and too inefficient for too long. The system is plagued with inefficiency, duplication, and variation which has lead us down a road of unsustainable costs, staggering rates of obesity, cardiovascular disease, and diabetes. Couple this with the increasing rates of elderly due to the baby boomer population and the future looks like a recipe for a healthcare crisis.

What is the solution?

While there is not one simple solution that will transform the current state of healthcare. Value based healthcare has emerged as an answer to the rising health care costs and inefficiencies. Although, the transition will not happen overnight, the shift to a system that is focused on improving value, quality, efficiency, and outcomes is certainly a step in the right direction.

How can M3-Patient Experience® help support the transition to value based care?

M3-Patient Experience is the proprietary patient feedback system developed and deployed by MedicalGPS, LLC.  Since 1995 physician practices have used M3-Patient Experience to gauge their patients’ perception of the office experience.  The process is simple, yet very powerful.  The goal is to acknowledge and express gratitude to every patient immediately following their office visit.  Patients are first thanked, and then encouraged to provide feedback relative to their visit – usually the same day or next day following their visit.   Patient feedback is obtained via in-clinic devices, email, and text message. 

The M3-Patient Experience questionnaire is customized by the M3 client and may include up to 13 of the core questions utilized on the CG CAHPS survey instrument.    M3-Patient Experience provides on-going continuous patient feedback relative to important CG CAHPS measures.  Because M3-Patient Experience is real-time, M3 clients have opportunities to; a) perform service recovery soon after the patient’s visit, b) build patient loyalty, and c) create a culture of service excellence, all of which results in positive impact to the patient experience. 

Organizations that use M3-Patient Experience as a supplement to their CG CAHPS process have on-going intelligence to continuously improve throughout the year.  As a result, when the annual CG CAHPS survey is conducted, organizations utilizing M3-Patient Experience score higher than they would have otherwise, and thereby maximize their reimbursement.

On-Demand Video Demo of M3 Patient Experience