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Value based strategy is the delivery of healthcare based on the outcomes of patient health at lowest cost. The providers are paid based on the health improvement of the patients and which helps in reduction of incidence of chronic conditions. The transition is from fee for service to value based which is supply driven depending on what providers do and towards patient centred system. Making this transformation is not easy. The healthcare leaders have an important role in this transformation in restructuring how this new system is organized, metrics measurements and the reimbursement methods. First challenge is defining a goal at senior management for sustainable growth is essential as it needs to depart from fundamental past wherein transition from volume based to value based with patient satisfaction as priority. The patient experience is enhanced by applying Integrated practice units to primary care services which resulted in patient centred medical homes. In this type of delivery model, management is responsible for emphasizing on chronic conditions like diabetes where appropriate treatment, preventive measures as well as education, medication regime and counselling, health behaviour changes like weight loss are put in place to gain patient satisfaction. This approach is effective for primary as well as preventive methods with measurable result for chronic conditions. Here the role of management is crucial where data is compiled shared and every process is closely monitored by creating a new model of integrated way. Second challenge is implementing value-based reimbursements which requires infrastructure, assessing the functional status of patient, and everything needs to be collaborated, integrating of medical records as well as financial data which requires personnel as well as resources. Patient Navigation is an effective strategy in value-based care with dedicated team like health administrators, nurses, social workers to provide guidance, support through diagnosis and deal with the barriers, ensure the timely treatment. Patient navigation is used mainly in oncology and geriatric care. With the help of navigators’ support continuity care in fragmented units where coordinated care is required, and to reduce disparities in low income group and focus is given to palliative care and the ultimate goal is provide better health with low cost. Under Centre for Medicaid and Medicare, bundled payments and Accountable care organizations (ACO) are used in acute and post-acute care where physicians receive single payment for acute, post-acute care for a episode period to prevent hospital readmissions which makes providers accountable that has potential to reduce cost without compromising the outcomes of results . Here role of administrators is significant as to maintain data because having reliable analytic data help physicians and providers to make right decisions at right time to make reimbursements as well as assessments in operations level of the organization. Thirdly even after decision of transition is made to value based care, data and insights needed are hard to obtain and requires time to complete them.

To succeed in value-based strategy healthcare leaders need to develop a plan which is sustainable advantage for both payers and providers and building solutions around their strengths. More emphasis should be laid on setting up technology like analytics big data which will help in avoiding the limitations that are currently present in organisation shifting. Today value base transformation is not a siloed organisation where it has specialities and discrete units, where care is not coordinated but through integrated practice units with help of efficient administrative leaders. Moving from fee for service to value care strategy is difficult and takes more time than expected but it is the best method for lowering health costs without compromising on quality and helping people leading healthy lives and the main focus should always be patient satisfaction.

References

P. (2017, March 2). Redefining Health: Implication for Value-Based Healthcare ... Retrieved October 4, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5376155/

S. (2018, February 1). Toward Value in Health Care Perspectives, Priorities, and Policy. Retrieved October 4, 2018, from http://www.ncmedicaljournal.com/content/79/1/62.full