How to Start the Value-Based Care Conversation with Clinical Leadership

Value-based payments are changing the healthcare financial landscape. In fact, by 2020, value-based reimbursement is projected to represent 83% of your revenue, up from just 14% in 2010. There’s no denying that clinical operations will become crucial to your hospital’s bottom line. Now more than ever, it’s important to engage with clinical leaders, arming them with the data, tools, and processes they need to make sure you’re adequately reimbursed for the care you provide.

Here are three ways to increase engagement with your clinical teams: 

1. Data Benchmarking 

One of the first steps in integrating clinical operations into the financial mix is gaining a comprehensive picture of your documentation and coding performance. The best way to quickly spot your biggest opportunities to improve revenue capture is through data benchmarking. With a holistic view of your financial health—in comparison to your peers—you can identify unspecified code usage, opportunities for greater specificity under ICD-10, and any physician training initiatives that may be needed to help fill documentation gaps.

2. Physician Training 

Your physicians can be reluctant to change. In the transition to a value-based care world, however, change is imperative. With analytics, you can engage physicians around data they find meaningful and actionable. You can then create physician champions and drive appropriate documentation specificity by offering detailed analytics and benchmarking data around the diagnoses that matter to them. 

3. Ongoing Monitoring 

As healthcare evolves, it’s important to develop a plan and process for ongoing monitoring of documentation, coding, and compliance. With a holistic view of your data, you gain complete visibility into how your clinical performance is affecting your bottom line, allowing you to reduce denials, measure the impact of ICD-10, and mitigate audit risk today and for reimbursement changes yet to come.

Approaching value-based care is an enterprise-wide responsibility. From the C-suite to physicians, everyone has a role in ensuring not that you find more revenue, but that you find the right revenue. A complete view of the revenue cycle can help you evolve with reimbursement changes without negatively impacting your bottom line.

Learn more about Revenue Integrity to help your clinical and financial leadership get the data they need to start the value-based care conversation. 

MedeAnalytics

MedeAnalytics is a leader in healthcare analytics, providing innovative solutions that enable measurable impact for healthcare payers and providers. With the most advanced data orchestration in healthcare, payers and providers count on us to deliver actionable insights that improve financial, operational, and clinical outcomes. To date, we’ve helped uncover millions of dollars in savings annually.