What Is Value-Based Care and What Does it Mean to a Provider?

Published in Member Communities on September 24, 2021

By Miriam Lieber, President, Lieber Consulting

As value-based care increasingly takes hold, outcome trends involving patient engagement and experience will continue to be the primary focus for healthcare providers. With that in mind, what is value-based care, and what does it mean to a provider? Value-based healthcare is a model of healthcare delivery—and reimbursement—that focuses on quality and patient outcomes. For example, we know that there is a correlation between patient adherence to a medical device and the patient’s outcome. We also know that this patient adherence will result in a reduced hospital readmission rate and, consequently, less healthcare expense. In this article, I will discuss value-based care from a DMEPOS provider’s perspective, including patient engagement and experience, compliance, telehealth, improved revenue, and user experience.

Patient Engagement and Experience

From everything we know about patient engagement, providers are accustomed to measuring patient satisfaction and experience as mandated for accreditation purposes. However, now that the referral community and consumer public better understand the solution is to keep patients at home (a silver lining of the pandemic as reported by HME News: “56% report the pandemic has caused patients, referral sources, and policymakers to view HME more favorably.”), how do we keep the patient engaged?

To do this, the provider must communicate with the patient at the right time, in the right place. For example, do not bombard the patient with advanced technology and digital solutions during setup. Once a patient’s equipment/supplies have been set up and the patient is taught how to use their device and work with your company, train them on their digital journey using technology. Specifically, teach them how to use the portal for resupply, to ask a question, to monitor their own compliance, and more.

Conversely, offer and proactively provide the patient regular check-ins, whether via phone, email, text, or virtual chat function, all of which must be HIPAA compliant. During the intake process, ask the patient/family for their preferred contact method in order of priority. Measure communication methods against patient satisfaction and hospital readmission rates to determine the most effective means of engaging patients. The aim is to promote superior patient satisfaction and ratings. The optimal way may be to reach out to their family members who will hopefully be interested in communicating via technology. Moreover, as baby boomers continue to age, they will be more acquainted with a digital healthcare environment and will prefer it as the most efficient way to communicate.

Telehealth and Compliance

Much of the digital journey begins with the doctor and hospital and the patient’s experience there. If the patient grows accustomed to using an online scheduler, online bill pay system, and online paperwork completion, their wait times will shorten. Further, since COVID proved that telehealth is a viable healthcare delivery option, patients understand that they can be seen by their doctor in a virtual environment when necessary. The domino effect is that providers can also provide equipment and supplies via drop ship and train the patient virtually using a digital experience and a telehealth approach, a dramatic increase since the pandemic. The majority of providers today will opt for drop ship of supplies and even durable goods.

During COVID (and even before), many providers trained patients on how to use a CPAP device virtually (via FaceTime, Zoom, or similar HIPAA-compliant methods) and for those who were able to connect with the respiratory staff, the experience was extremely effective. For your company, you should measure and track such outcomes to ensure you are meeting patient satisfaction protocol and your ratings are high. Make adjustments based on results. Report positive outcomes to the referral source, as always.

Not only will the referral source be inclined to partner with you as they delve more deeply in value-based care, but it will also provide synchronous methods when working with the patient from the acute care setting to the home. With virtual patient education and convenience of training, patients get used to a more efficient and prompt means of teaching them how to properly use their equipment. Further, by monitoring the device from an application on a phone or minimally from a portal, compliance can be measured, and issues can be resolved more hastily than before. Consequently, you will avoid exacerbating clinical and psychologically negative outcomes.

Additionally, with increased awareness of digital opportunities, patients will more readily rely on online scheduling, online bill pay, resupply ordering, and more. In fact, patient portals and user applications are becoming the norm in all of healthcare (even the payer portals are increasingly more user friendly) which will help your company gain traction in this area. Not only will these experiences enhance credibility and patient dedication, but they should also enhance compliance rates. Moreover, the patient should become more knowledgeable about their care and will hopefully improve adherence to the requirements specified by their insurance payer. Specifically, they will be reminded about utilization guidelines, resupply allowances, and intervals when attempting to reorder, etc.

Reduced Costs, Improved Revenues

As patients become more aware and accustomed to using digital means to access to their healthcare, costs reduce and revenues improve. Moreover, the patient and/or caregiver can more easily order ancillary products that improve quality of life, all of which can be drop shipped and purchased in a seamless online experience. Research shows baby boomers are more apt to pay cash for products when they have a higher understanding of their health-related issues.

Further, patient satisfaction, the most compelling objective of all, should improve dramatically. Measure user experience and satisfaction and make modifications swiftly, as needed, to ensure your company’s success. Do this to build trust and nurture patient relationships. Knowing that your company gets the best customer reviews when a referral, payer, and patient search for a provider will prove to be your differentiation factor and result in your long-term success in value-based care and today’s HME world.

About the Author

Miriam Lieber is an independent consultant and trainer specializing in homecare reimbursement and operations management. Her extensive experience with Medicare and other third-party payers has brought her national recognition in the homecare industry. With over 25 years of experience in the homecare field, Miriam is a featured author of many articles in the areas of operations management and leadership. She is also a nationally known speaker for many homecare trade associations. In her consulting practice, Ms. Lieber’s clientele includes, home healthcare companies, managed care organizations, hospitals, wholesalers, pharmacists, and manufacturers. She is known to have practical approaches to complex reimbursement matters and assists her clients with the nuts and bolts of running a profitable business.

This article was originally featured in the VGM Playbook: How Serving Your Customer Serves You. To read more articles like this, download your copy of the playbook today!

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1. customers
2. operations
3. playbook
4. telehealth