In order to be successful moving forward, home-based care providers will need to understand the value-based care landscape and be prepared to operate in this space.
That’s one key takeaway from a new report released by Transcend Strategy Group, an at-home care-focused growth strategy firm. The report is an overview of value-based care’s history, as well as a guide to help providers operate in a larger value-based ecosystem.
In general, home-based care providers are staring down the barrel of a health care landscape that is increasingly embracing value-based care.
Specifically, the Centers for Medicare & Medicaid Services (CMS) has been vocal about its goal of having 100% of all Medicare beneficiaries in a value-based program by 2030.
There are ways that providers are already embracing value-based care, according to the report.
On the home health side, providers are forming arrangements with Medicare Advantage (MA) plans and operating under the Home Health Value-Based Purchasing (HHVBP) program, while home care providers are often offering personal care services as part of MA plans’ supplemental benefits.
The report also highlighted a number of programs that are driving value-based care, such as the Medicare Choices Model, HHVBP, ACO REACH and the GUIDE Model.
As health care shifts further into the value-based care space, it’s critical for home-based care leaders to prepare their organizations for this change.
“You have to be thoughtful and strategic about all of this,” Tony Kudner, chief strategy officer at Transcend, told Home Health Care News. “Some agencies think, ‘We’ll just get the right data set, and that’ll be our value-based initiative for the year or we’ll hire one person who deals with contracting.’ We think about it in terms of six steps.”
The key steps that providers need to take include: defining and tracking value; determining risk tolerance; identifying potential payer partners; having strong data; preparing front-line and mid-level staff; and preparing for any other challenges ahead, according to the report.
Ultimately, providers will no longer be able to sit on the sidelines and avoid engaging in value-based care, according to Kudner.
“The status quo will not hold,” he said. “Relying on your episodic business to offset the losses that some providers are taking on the MA side is not a sustainable business model, nor will it help you grow in the long term. On the home care side, I think the same thing is true. Building resilience at this point, and being able to proactively offer delegated risk providers solutions to help them manage their global spend, will be more successful than trying to simply grab as many hours as are allotted by a health plan through Medicaid for a patient.”
What’s more, Kudner believes that providers that don’t engage with value-based care could see it negatively impact their organization, in comparison to competitors.
“Expanding your skill set is going to be table stakes,” he said. “If you don’t do that, you’re going to see the other providers who are trying to adapt to this changing landscape start to get those referrals.”
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