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    5 reasons why your EHR isn't enough for success in value-based care


    3)     Revenue cycle management (RCM) focused on alternative payment models and risk. In the fee-for-service era, RCM equaled a rigorous focus on getting claims paid faster and more accurately, while removing administrative burden. Value-based care has changed this mainstay, too. Practices now need RCM at the forefront of their financial planning. This means forecasting performance against both traditional and alternative payment models, while managing risk and shared performance incentives to ensure overall health. It is also essential to manage complex reimbursement calculations, driven by cost and quality outcomes that are variable across payers.


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    Smaller practices that lack the resources to make these investments solo should look for opportunities to band together in geographies, payer networks or even specialty associations to share infrastructure—ideally, as part of an alternative payment model effort of their own.

    The acceleration of value-based care brings with it the need for practices to rethink the skills, teams, workflows and toolset that will help carry them to success. The EHR, so central during the Meaningful Use years, is becoming just one among many elements required to equip providers to understand and manage the cost and quality of their patients. The capabilities of the future align around the ability of multidisciplinary teams, equipped with powerful data and evidence-based pathways, to care for their patients holistically across all health issues and care settings. While the journey may seem daunting, it is one that is both worthwhile and necessary to embark upon as the healthcare system increasingly shifts toward value.


    Charles Saunders, MD, is the chief executive officer of Integra Connect.

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    • UBM User
      Congratulations to Mr. Saunders (he forfeited the title "Doctor" some time ago) for the most audacious pile of garbage I've read recently on Medical Economics. And that's saying a lot.

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