Strategies of Establishing Value-Based Care (Coursework Sample)

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Strategies in improving value-based care
The healthcare system in the United States is currently trapped in its uncooperative teenage phase, whereby it is pointed in the course of rewarding value over volume, however not close to the natural and universal value-based reimbursement. Various stakeholders are finding means of creating health plans with the providers being engineered to lower-cost, ensuring that quality has been improved; nevertheless, the healthcare system remains, majorly operating on a fee-for-service reimbursement model (Jain, Thorpe, Hockenberry, & Saltman, 2019). Whereas most players in the healthcare sector regard the transition to value over volume as inevitable, many barriers in attaining value-based care remain a menace. Without a doubt, the healthcare system in the country is indeed in its initial stages of a value-based care evolution; listed below are three strategies aiming at improving value-based care.
The first key strategy is focusing on high-value care. The healthcare organization should develop systems that enable the whole organization to drive attendance at a lower-cost setting able to provide equal or higher value care (a patient's health outcome defines value in this case). In the following avenue, "data and analytics" can play a central role in recognizing areas in which high-value opportunities are present. For instance, upon being discharged from the medical facility, the physician in charge recommends that his elderly patient with comorbidities gets admitted to a long-term-care facility. Nevertheless, in such a case, the analytics might reveal that a patient with similar comorbidity and social health determinants has since historically recorded better health outcomes from in-patient home care.
In such a case, the physician thought that he took medically appropriate actions in reducing the patient's chances of long-term complications by referring the patient to a long-term care facility, however through analytic, the physician could have identified a better treatment plan. Whether about the choice of device, drugs, facilities of procedures, data holds the potential to assist providers and payers, uncover opportunities likely to help in the reduced cost, and at the same time able to improve patient outcomes under value-based care.
The next possible likely to enable the healthcare facility to improve value-based care involves the healthcare facility learning to invest in its network; through this, the facility determines patients' movement through a delivery system and carefully keeps track of the patients all through the continuum of care. In value-based reimbursement, it will be essential for the healthcare facility to improve on the management of population health and care coordination, as well as ensuring it attains the right outcome among patients while at the same time balancing costs and consequences (Jain, Thorpe, Hockenberry, & Saltman, 2019).
The critical component in the second step is that the network participants will all be expected to align themselves from an incentive viewpoint towards reducing cost and improving care. Conversely, through leveraging analytics, the providers and payers get to obtain archived information in designing contracts that properly align their monetary inducements. On the other hand, deals that align in the right way, the network participant incentives, as a result, can bring about a reduction in the necessary utilization of high-cost treatments and admission to hospitals (Peterson, 2018).
The third step in improving value-based care consists of measuring meaningful outcomes for patients and costs for every patient's entire cycle of care. In as much as this appears daunting, duplication and waste can only be identified at patient levels. It is through measuring an outcome that health care delivery is encountered; this will implement the time-driven activity-based costing essential in estimating and understanding the cost at the patient level (Galvin et al., 2019). Additionally, the time-driven activity-based costing shall expect the clinical team to come up with process maps recording all the patient's data from the start of their hospital stay until they are being discharged.
Strategies of value-based purchasing barriers and how the leaders may overcome the barriers
At a glance, creating a healthcare system that emphasizes lowering costs appears to be counterintuitive in an environment focused on rewarding quality improvements. However, the challenge currently faced by finance executives includes reducing costs while improving quality and combining the two in seeing to the existence of a thriving bottom line. This a manageable challenge was given that the healthcare system tackles the task with a sufficient understanding of what position it takes relative to the clinical quality measures and the cost linked with delivery of care (Gillingham, 2019).
For finance executives, the necessity to account for clinical quality in predicting the organization's financial health remains a fundamental paradigm shift. Similarly, with the clinical metrics portraying a more significant impact on the bottom line, the business executives in a healthcare environment are likely to face numerous challenges, such as how the parameters can be tracked, analyzed, measured, and translated into financial terms. The significant barriers that exist to leverage data effectively in driving value-based decision-making include financial and clinical data siloes and the existence of an outdated process in reporting (Galvin et al., 2019).
The healthcare system can overcome challenges faced and, as a result, successfully managing cost in a value-based environment by finding effective means to leverage the two most essential assets for quality change and effecting value; data and clinical teams. To use clinical and financial data more efficiently in driving sustainable improvement, the organization can then develop permanent, multidisciplinary, frontline teams capable of leveraging the aggregated financial and clinical data aimed at encouraging sustainable development. Such frontline teams consisting of quality personnel, clinicians, technologists, and analysts should be supported by the financial representatives. The following approach will engage the frontline personnel, enabling them to drive quality improvements.
Conversely, the teams should engage together to determine their capability in improving specific outcomes for which the organization is held liable, implementing the organizational goals as guidance alongside implementing the protocols believed to be most effective (Pruitt & Moseley, 2018). Similarly, plans should also be monitored continuously to emphasize majorly sustaining quality financial improvements and operational and clinical outcomes. Such type of change has higher chances of empowering the entire team in identifying improvement opportunities and enabling the organizations to glance at how the quality over cost equation improves through their efforts.
Even though the frontline team is considered the helm of the quality initiative to be truly useful, the teams will need to report to a guidance team consisting of members of management that are capable of eliminating roadblocks, setting clear goals, and prioritizing work efforts for the whole healthcare facility. The frontline teams should also remain permanent and not be dissolved in attaining the goals (Galvin et al., 2019).
Discuss the role of leaders, at any level, in optimizing value-based services.
There is an underlying concern that most medical professionals are not well prepared to comprehend the nature of leadership or even take leadership roles given the lack of leadership content in the undergraduate course curricula. Leaders at any level of optimized value-based service have numerous functions, such as demonstrating the desire to increase awareness, primarily when referring to personal strengths, values, and failings. They consistently search for a conviction alignment with their works and leadership competencies feedback; this enables them to pursue more significant and more critical challenges (Gillingham, 2019). Besides, the value-based service leaders should also identify where project organizational discipline and structures meet and create an interface between the responsibilities and boundaries, making the leaders stronger and open through a genuine effort in improving the healthcare facilities' goals.
A value-based service leader should also understand the importance of having all individuals take part in the project leadership. Planning is also essential as it initiates necessary actions that create momentum and results. It is necessary to note that the efforts spent on planning are critically evaluated against all the stakeholders' benefits, cost, and risks (Pruitt & Moseley, 2018). The service-based leaders should continuously have a plan that assists them in initiating actions at a moment's notice once the stakeholder is ready.
Conversely, the service-based leader should also personalize their roles to every team member and its customers to create unique goals and develop effective strategies. Nonetheless, there exist numerous traits of a service-based leader that embody the