Medicare’s New Value-Driven Purchasing from LTPAC

SNF Value-driven purchasing (VBP) is a new Medicare payment program supported by the CMS and is aimed at shifting reimbursement "from volume to valueSNF Value-driven purchasing (VBP) is a new Medicare payment program supported by the CMS and is aimed at shifting reimbursement “from volume to value.” This new framework is intended to prioritize the holistic needs of the patient, rather than simply focusing on the volume of services that a patient receives. Value-based payments seek to disincentivize healthcare providers from ordering unnecessary testing and procedures; instead, they can focus on what truly works for patients. Beneficiaries will receive care consistent with their own unique needs and goals, while overall cost effectiveness will be improved. In addition to better serving patients, values-based payments aim to reduce the administrative burden of LTPAC and other healthcare facilities.

In order to effectively enhance the value offered to patients, healthcare providers will be driven towards more robust software systems that process data in a multi-dimensional manner. A data-driven EMR should capture and categorize each discrete element of data, thereby aiding the clinician in assessing, planning, ordering, charting, and documenting patient care. These measures will also support the coordination of care and effective prevention and treatment while easing the strains on the healthcare facility, just as the new CMS guidelines emphasize.

From the EMR vendor’s perspective, the above processes require categorization of data in a very high resolution, in order to enable the utilization of advanced data management techniques. Depending on the needs, the EMR suite will also be able to extract any report according to the different dimensions required by different stake holders.

Value-based care and payments require preparation and support by an adequate information management system. When properly implemented, they are a win for everyone involved: they lead to better care for individuals, improved population health management strategies and reduced healthcare costs.

Doron is Chief Software Architect for LINTECH LLC, which has been providing integrated clinical and financial information systems to the LTPAC market for over 30 years.