The Shift from Volume to Value: The Challenges

Now that we have covered the basics of volume-based reimbursement and value-based reimbursement and all of the wonderful benefits it will bring, we will address some of the anticipated challenges your healthcare facility might face.

In Case You Missed It

Healthcare providers are currently shifting from volume-based reimbursement plans to value-based reimbursement. This dramatic change is designed to benefit patients, healthcare providers and the payers. Value-based reimbursement promises to give patients the highest quality care for the lowest possible amount and shift the focus of healthcare providers to the actual health of their patients.

Medicare and Medicaid

As the baby boomer population grows older and more reliant on Medicare for their medical expenses, the reimbursements that healthcare facilities receive will decrease. In addition to the growth in Medicare patients, the use of Medicaid has also grown. The new mix of revenue will definitely take a toll on your office’s bottom line if you are not prepared.

Reconciling Volume-Based and Value-Based Payments

The next challenge healthcare providers face is reconciling the new value-based reimbursement model with your current fee-for-service environment. Tracking progress can be tricky, as you need to maintain detailed logging in two different payment systems at the same time. Your accounting systems and software might need a major upgrade in order to track value-based reimbursement patients, populations, and billing.

Keeping Track of Quality Measures

Most incentives for practices that meet certain value standards rely on keeping track of quality measures. You are probably already used to submitting some quality measures, but their effect on your bottom line might be new. The value-based reimbursement shift means that your ability to meet quality standards, benefit patients and cut costs is directly tied to whether or not you receive incentives or penalties.

This transition period is the perfect time to have an evaluation performed on your facility’s systems to see where you can further reduce costs and increase efficiency. Vetters Enterprises specializes in practice management, revenue cycle optimization, and private practice business support. We can perform detailed assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

Provide Quality Care through Tele-mental Health Consultations

The National Alliance on Mental Illness reports that anxiety, depression, substance abuse and other psychological ailments affect nearly one in five Americans, or 43.8 million people. However, it can be difficult for people with behavioral problems to seek help from a mental health professional and receive an accurate diagnosis. Mental health services are often offered in abundance in urban and suburban areas, making it difficult for people in rural areas to conveniently access the help that they need. That’s where tele-mental health comes in.

 

What is Tele-mental Health?

The Tele-mental Health Guide defines tele-mental health as “the provision of mental health services using live, interactive videoconferencing.” It makes sense, doesn’t it? In an instant we can use videoconferencing to virtually connect face-to-face with our friends, out-of-state relatives and business associates – so why not use this technology to serve mental health patients from afar? Tele-mental health consultations are an increasingly popular way to provide quality mental health services to those living in underserved communities with limited clinicians.

What are the Benefits of Tele-mental Health Services?

Without convenient access to mental health services, those suffering tend to neglect seeking proper treatment. Who wants to drive 200 miles out of town to the closest specialist for continuous care? In the past, patients were forced to make that kind of time and shell out for gas, potential childcare and missed work days if they wanted to be seen. Tele-mental health consultations provide mental health access like never before for both doctors and patients. Some of the benefits associated with tele-mental health services include:

  • Access to patients worldwide, resulting in an increased patient pool for practitioners
  • Ability to facilitate an immediate 3-way consultative session with a specialist through video conferencing, allowing for more comprehensive care on the same visit
  • Higher consumer and practitioner satisfaction
  • Increased convenience and efficiency
  • Minimized/eliminated travel costs for patients
  • Increased comfortability for those who find it difficult to open up to specialists in person
  • Same day psychological test results
  • Reduced emergency care costs (by diagnosing and treating illnesses earlier on).

What is the Goal of Tele-mental Health Services Moving Forward?

The primary goal of tele-mental health services is to provide patients with the highest quality comprehensive care. Many clinical groups and medical professionals that have employed tele-mental health capabilities have reported that the efficiency of remote care is on par with in-person care.

Want more useful information? Visit our blog again! Vetters Enterprises is a full service practice management company specializing in practice management, revenue cycle optimization and private practice support. Contact us today if you’d like to see how we can help you improve your cash flow.