Value Based Medicine: Reimbursement Changes

Big changes are coming to medical reimbursements, and they are coming soon. This is the massive switch from a fee-for-service model to what’s been dubbed “Value Based Medicine.” This change does require some pretty significant mindset and process shifts, but it’s not the end of medicine or even private practice as you know it. In fact, if you are prepared and embrace the change, you can thrive in the field.

So What Is Value Based Medicine, Anyway?

Value Based Medicine is a model of reimbursing doctors and hospitals based on patient outcomes and the cost of seeing them, rather than directly for the services you've provided. Up to this point in time, reimbursements have followed a fee-for-service model of paying out, which means you bill for the specific services you provide your patients.

We are now entering a new era in which the focus for reimbursement models is based on measuring costs for seeing patients as well as their treatment outcomes. The goal of this program is cost containment and hopefully improving patient care.

Making the transition to this model for reimbursements successfully, however, requires a huge shift for podiatric professionals in how they think about treatments and how they measure outcomes.

So Does This Mean I’ll Be Reimbursed Less?

As all doctors know, your reimbursements have already been dropping over the last several decades. Even as inflation has increased, reimbursements for common procedures and even simple treatments have decreased. This is part of why doctors feel they have to see more and more patients in a day to maintain their profits, much less improve them. There is an opportunity for smart doctors to not just survive under this new model, but actually thrive under it. However—and this is important—you will have to carefully track data in your electronic medical records regarding patient outcomes.

This data will then help measure your performance to see how well you are providing the best possible service and care for your patients as well as how you are minimizing treatment costs. The better you do at tracking your data along with providing the best possible care and outcomes, the better your reimbursements will be. That is why your data matters so much.

Fail to keep rigorous track of your outcomes or fail to “perform,” however, and your reimbursements will be penalized and “adjusted,” and that will cost you money.

How Top Practices Can Help You Prepare

Plenty of doctors are worried about this shift in reimbursements and the many potential pitfalls involved, but the changes are coming whether you like them or not. The best thing you can do is be prepared, which is where Top Practices can help. We have teamed up with Collaborative Practice Solutions to create the Virtual Practice Management Institute (VPMI) program to help provide the data analysis and information doctors need to make sure they are “performing” in their practices. More than that, the program provides you with a unique opportunity to get in-depth coaching, mentoring, and training to improve your office management and truly meet the challenges of practicing modern medicine. You can learn more about how this program works and all it offers here on our website.

Big changes are coming to medical reimbursements and you can’t afford to stick your head in the sand and hope things will blow over. You WILL lose money that way. Now is the time to prepare and set your practice up to succeed through these changes to your reimbursements. If you’re at all interested in the VPMI program or otherwise rising to meet the challenges of practicing modern medicine, contact us today! You can call (717) 725-2679 or email us at [email protected]