What are the four conceptual templates for value based care? Is the compensation really worth it? We give you the answers here in this insightful slide-share.

1. QUALITY
OVER
QUANTITY
BY TXCIN
WHAT VALUE-BASED
CARE MEANS FOR
PROVIDERS

2. The age of value-based healthcare
is here, and the Centers for
Medicare and Medicaid Services
(CMS) has taken the lead in
healthcare delivery and
reimbursement reform. The
strategy is driven by a three-part
aim to offer better quality health,
to improve patient healthcare
experiences, and to deliver services
at lower costs.

3. QUALITY
In the transition to value-
based care, providers are
challenged to operate in a
state of payment duplicity,
working in a declining,
traditional fee-for-service
(FFS) reimbursement
model, while preparing for
and participating in value-
based contracts and
payment models.
COMPENSATION

4. QUALITY
Quality and efficiency are the
goal of every value-based
payment model, and CMS’s
intention is to eventually
transition every provider from
fee-for-service to value-based
care, linking provider quality
performance to provider
compensation. In this new
strategy, an increasing amount
of provider compensation is
based on quality performance in
areas of patient and caregiver
experience, care coordination
and patient safety, preventive
health, and clinical care for at-
risk populations.
COMPENSATION

5. If the value-based methodology of
quality-over-quantity is embraced,
healthcare providers may experience
greater freedom in how they practice,
and they may see significant
compensation as a reward for attaining
and improving quality performance over
time.
http://www.insight-txcin.org/post/quality-over-quantity-
what-value-based-care-means-for-providers

6. There are four
conceptual “templates”
for value-based care,
and each consists of
multiple models specific
to specialty, episode,
and patient population:

7. A
V
L
Pay-for-Coordination: a primary care physician
leads and coordinates care between multiple
providers and specialists to manage a unified care
plan for patients and to ensure efficiency and
quality; e.g., the Patient-centered Medical Homes
(PCMH) model.
Pay-for-Performance (P4P): healthcare providers
are incentivized to meet certain quality and
efficiency benchmark measures. Physician
reimbursements are directly related to achieving
these performance measures; e.g., the Hospital
Readmission Reduction (HRR) program and the
Skilled Nursing Facility Value-based Program
(SNFVBP)
U
E

8. A
B
S
Bundled Payment or Episode-of-Care Payment: this
model encourages quality and efficiency because
healthcare providers are reimbursed with a set
amount of money to pay for a specific episode of
care, such as a hip replacement, and any
complications. Providers keep any realized net
savings; e.g., the newly launched Bundled Payments
for Care Improvement—Advanced (BPCI--Advanced)
model and the Comprehensive Care for Joint
Replacement (CJR) model.
Shared Savings Programs (one-sided and two-sided
risk): physicians form entity groups and provide
population health management. Quality and
efficiency are achieved through coordinated, team
care and any realized net savings are given back to
the provider: e.g., Accountable Care Organizations
(ACOs).
E
D

9. QUALITY
The value-based healthcare
environment is one of
collaboration, a team mentality
where providers are expected to
work together to engage with
patients, to provide care
appropriate to each individual’s
circumstances, and to align their
efforts with multiple partner
providers across the healthcare
continuum. This strategic shift in
quality healthcare is extremely
beneficial to patient populations
because it delivers a connected
care experience where patients
receive more coordinated,
appropriate, and effective care.
COLLABORATION

10. THE ACO ROLE
Accountable Care Organizations (ACOs) are the
premier example of collaboration within the value-
based care strategy. ACOs are entity groups consisting
of networks of physicians, specialists, surgeons,
pharmacies, and hospitals who agree to coordinate
care for a patient population, with the goal of
improving quality care, while eliminating unnecessary
spending. ACOs are instrumental in the long-term
strategy of coordinating care to improve quality and
value, and this collaborative approach is helping
providers to realign their methodology to focus on
value-based care rather than volume-based care.

11. Want
More?
http://www.insight-
txcin.org/post/quality-over-
quantity-what-value-based-
care-means-for-providers

12. ABOUT
TXCIN
North Texas Clinically
Integrated Network, Inc. (dba
TXCIN) is a non-profit ACO
that began in late 2014. A
small group of independent
physicians aligned to initiate
clinical integration and value-
based contracting. Partnering
with RevelationMD and its
state-of-the art information
platform, TXCIN has become
the largest independent
network of physicians in North
Texas.