Healthcare News & Insights

Value-based care: One health system’s success story

Making care more value-focused is a significant challenge for many hospitals. When budgets are strained and resources are limited, improving quality while cutting costs can seem daunting. But some hospitals have managed to achieve positive outcomes while saving millions of dollars – so it can be done. 

87462398One health system in Utah set a lofty goal: Lower patient care revenue by $700 million dollars in a year. And with the changes it’s made so far, it’s on track to meet the mark.

As described in an article from Hospitals & Health Networks, Intermountain Healthcare wanted to get ahead of the curve with value-based reimbursement so it would have a proven strategy to use once Medicare and other carriers started paying hospitals based on quality.

Intermountain began by adopting a global budgeting approach to allocate a set number of resources to each of its hospitals and clinics.

Using its IT resources and taking advantage of its network of primary care physicians, the health system implemented several strategies to improve the value of its care, including:

  • using medical records information to identify and help high-risk patients
  • taking a “medical home” approach to primary care
  • creating multispecialty clinics for patients with complex conditions
  • adding behavioral health treatment to patients’ primary care, and
  • integrating drug, nutrition and lifestyle coaching into primary care visits.

These changes helped Intermountain achieve significant cost savings while keeping patients healthier and out of the hospital.

Changes to make

Not every hospital has the same resources as Intermountain does. But there are still smaller things each facility can do to improve its value-based care, including improving care coordination by working closely with local primary care providers and clinics. Per the article, it’s a good idea to focus on a specific patient condition, such as heart failure or diabetes.

It can be tough to know where to start when shifting your focus to coordination of care. According to the article, taking a team-based approach is the best way to begin. Dedicate different care teams to specific patient groups. Each care team can brainstorm ideas for its assigned patients.

Over time, having the team work with the same patients can increase their engagement in the process, which not only leads to better patient outcomes, it also decreases levels of provider burnout.

Building relationships with patients is a critical part of success with value-based care initiatives. It promotes consistency across the continuum of care, and it makes both patients and providers more invested in the outcomes of treatments.

Also key: developing a consistent set of processes to treat each type of patient and using them all the time.

Hospitals that want to thrive under value-based purchasing would be wise to start looking into these changes now, so they can refine their care processes and fix any big issues before they have a significant effect on their reimbursement.

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