If you think that we will see a continued expansion of the use of value-based reimbursement (VBR) for specialty provider organizations, the next logical question: Is your organization ready?
There are many facets to “readiness” (see The Value-Based Reimbursement Steeplechase and Taking A Functional Approach To Succeeding With Value-Based Reimbursement). But, needless to say, the right technology is a critical piece. It is no surprise that investments in technologies that support VBR are predicted to grow 34% over the next eight years, from $600 million in 2017 to $6.4 billion in 2025 (see IT Spending Follows The Money). And, topping that tech investment list is getting a fully functional electronic health record systems (EHR) (see EHRs & Satisfaction-Of Both Consumers & Clinical Professionals).
EHRs provide the “chassis” for the data that provider organizations need to succeed with VBR. But how do you know if your EHR is up for the challenge? In his presentation at The 2018 OPEN MINDS Performance Management Institute, A CFO Insider’s Look At EHR Return On Investment, Credible Behavioral Health chief executive officer Matthew Dorman shared some perspectives on the key functionality required for EHRs to support value-based contracts and explored the ten most interesting factors that affect EHR implementations and the ten most important strategic capabilities for your EHR. Of those, three strategic capabilities stood out me as essential for success with VBR – integration with financial systems, enhanced billing capabilities, and user-friendly access to data with flexible reporting.
Integration with financial systems – To successfully manage value-based reimbursement, knowing service costs is essential. Both the cost of their own services and the services they purchase on behalf of consumers. This requires the ability to combine fiscal data systems with clinical performance management. If your EHR doesn’t have the ability to integrate with some kind of accounting system, or the ability to export data out, it is missing a key ingredient to make it compatible with managing value-based reimbursement models (see What Do You Need To Demonstrate & Manage Your Value?).
Enhanced billing capabilities – If fee-for-service billing is replaced by new reimbursement models, that means new billing system requirements. Case rates, bundled per diems, and capitated reimbursement models—all with performance-based bonuses and penalties—present new challenges for billing. At the same time, provider organizations need to maintain their ability to attribute individual services to those new reimbursement models. Your EHR should be the foundation for billing in this new environment (see Do You Understand The Cost Of Value?).
Flexible reporting – Managing value-based contracts require organizations to manage to performance targets. This requires a data-driven culture with access to “real time” data. The current state of value-based reimbursement is far from standardized, which means provider organizations need the ability to record and report a wide range of performance information. (For more on that, see my closing keynote from the institute, The Transition To Value: Addressing The Challenges Of Performance Measurement, Talent & Capital.) This is one of the most fundamental capabilities for success with VBR, and one Mr. Dorman said you should expect from your EHR (see From Data Modeling To Data-Driven Decisions and You Have An EHR, But Can You Share Data?).
If your organization sees performance-based contracting in its future, now is the time to step back and take a look at your “EHR chassis.” To find out how your organization compares to your competitors, don’t miss next week’s presentation of our national survey results in our free web briefing, Lessons Learned From Hundreds Of Agency EHR Implementations: Results Of The 2017 National Behavioral Health EHR Survey.
For more on technology strategy, check out:
- Your Tech Functionality Checklist For Value-Based Reimbursement
- The Tech Checklist For Value-Based Contracting Success
- You Have An EHR, But Can You Share Data?
- Technology = Data = Management
- Financial Optimization – Getting Paid For What You Do
- The Strategy Of Tech Investment
- How To Build A Successful Technology Plan: From Innovation & Strategy, To Budgeting & Selection
- More Tools For Tech ROI
For more on ensuring that your system has the right EHR in place, join OPEN MINDS Senior Associate Joseph P. Naughton-Travers, EdM on October 22 at The 2018 OPEN MINDS Technology & Informatics Institute executive seminar, “How To Find The Right Electronic Health Record: The OPEN MINDS Seminar On Best Practices In EHR Selection & Contracting.”