The CAPC Payment Accelerator: A Joint Virtual Workshop for Home-Based Care Teams-CAPC Payment Quick Tips

CAPC Payment Quick Tips - Value Based Payment Introduction

Pdf Summary

Value-based payment is a model in which the quality and/or cost of healthcare are considered when determining the payment providers receive for their services. The goal is to achieve high-quality care at the lowest possible cost. Palliative care is a valuable component of value-based payment as it helps manage symptoms, reduce hospitalizations, and improve quality of care while keeping expenses down. Palliative care providers should pursue value-based payment as it aligns with the interest of health plans and other entities responsible for cost and quality. These entities are focusing on high-need/high-cost patients who are likely to benefit from palliative care. Value-based payment can take different forms, such as provider bonuses for positive performance or penalties for falling short. Common value-based payment models include specialized fee schedules, fee-for-service with shared savings/losses, add-on fees for case management, and case rate payments. Providers can participate in value-based payment without taking financial risk by opting for models that only offer shared savings or fixed case rate payments. Palliative care providers can demonstrate their value in a value-based world by presenting data on their program's performance in important quality measures such as patient satisfaction, hospital utilization rates, readmission rates, advance care planning, and hospice utilization. In addition to data, case studies of real patients can bring the impact of the program to life. Additional resources are available, including toolkits on demonstrating value to stakeholders and measurement best practices.

Keywords

value-based payment

healthcare quality

cost of healthcare

palliative care

symptom management

hospitalizations reduction

quality of care improvement

health plan alignment

high-need/high-cost patients

provider bonuses