With the change to value-based reimbursement and patients living with chronic conditions, practices may need to evaluate their care delivery model design. With the shift, payers are making reimbursement decisions based on the delivery of high-quality, cost-effective care.
A few key areas to consider include:
- Are you providing valuable and appropriate education on the patient’s disease state and treatment plan?
- Does your practice offer advance care planning services so patients can express their wishes as desires for their care?
- Are you offering screenings for depression or psychosocial distress?
- Does your practice offer self-care management support to patients and families to help them understand their role in managing the illness, make informed decisions about care and engage in healthy behaviors?
- Do you involve your patients in shared decision making?
- Do you have an internal source to help patients and their families financially navigate their care?
- Is your practice following nationally recognized clinical guidelines for treatments?
- Do you offer effective care without overutilization or underutilization of services?
- Does your practice offer care coordination services, involving the patient, to facilitate the appropriate delivery of care?
- Are you using a team-based approach to care delivery, potentially reducing the fragmentation of care?
- Have you instituted a symptom management triage system to manage patients’ side effects and symptoms?
- Do you offer transportation and translation services to patients, so they can make appointments and understand fully their treatment plans?
- Does your practice provide access to clinical trials?
Access to Care
- Do your patients have 24/7 access to a provider in your practice who can review their electronic medical record (EMR), to avoid costly ED visits or hospitalizations?
- Does your practice offer same day urgent care visits, after hours and/or weekend care services?
- Are new patients referred to the practice seen within 48 to 72 hours?
- How long is time from initial visit or diagnosis to treatment? Can you shorten the time?
- Have you created a partnership with urgent care facilities who might offer treatments like hydration or infusion to avoid those ED visits when your practice is closed?
Listed above are only a few of the areas to consider when redesigning your practice to be a patient-centered care delivery model. In the next ION Informs, our clinical quality consultants will discuss the other areas to evaluate when considering your practice’s operations.
For more information regarding how ION Solutions can help with practice redesign: