What You Need to Know About the Transition to Value-Based Care

By Emily Royalty-Bachelor, Staff Writer - April 24, 2018

Valued-based purchasing is coming to long-term care facilities nationwide—and it’ll be here before you know it.

This payment model is designed to support the practice of resident-centered care—which many long-term care facilities have already implemented to some degree. Still, in an industry with deep traditional roots, particularly in regard to reimbursements, the shift in payment model may be jarring—and preparing for the change may be overwhelming.

But it doesn’t need to be.

With the help of a few tools and a little advance planning, you can help make your facility’s transition to value-based care a simple one.

It's important that we stay ahead of the curve, and that's always a challenge,” says Michelle Bulger.

Bulger, alongside Patty Embree, vice president of innovation at Vincentian Collaborative System, will be co-instructing a conference session at the 2018 AADNS annual conference in National Harbor, MD, on this very subject. The June 29 session, called “Making the Move to Value-Based Care,” will shed light on practical, actionable steps and tools you can implement within your own facility today to prepare for this coming change.

 

What does the new value-based care payment model mean for my facility?

Value-based care means that your facility reimbursement will be impacted based on the quality of the services you offer, rather than the volume of beds filled (i.e., how many residents are admitted to your facility).

Now that all resident voices are being heard during Department of Health surveys, the resident experiences have a more significant impact on quality ratings. This means that maintaining the quality of your resident experience will be crucial not only from the perspective of resident-centered care but also for the level of your reimbursement.

The concept of being scored based on value is nothing new; facilities in the post-acute care setting are already scored on quality initiatives and Five-Star ratings. These initiatives will serve as a foundation to the new payment model. The tools that Embree and Bulger will be sharing in their conference session are designed to help your facility gain stars, which will in turn prepare you for the move to value-based care.

“Those requirements are already in place. We are already being measured on our satisfaction, our health inspections. We're looked at from a number of different quality initiatives, and we're being rated on that,” says Bulger.

This transition has already taken place in acute care, and the post-acute care setting transition is underway.

“A similar model existed in acute care. It progressed from being acknowledged for reporting on your performance, to being paid for your performance. Based on those scores, you were at risk of losing payment from CMS,” says Bulger. “If post-acute care mirrors what happened in acute care, you want to be prepared for that.”

 

How will this conference session help me prepare my facility for value-based care?

Exactly how value-based care will impact your facility is dependent on each individual site and what its specific deficiencies are, says Embree.

Fortunately, Embree and Bulger have a tool to help you identify yours, and they’ll be sharing it with their session attendees.

“What’s so nice about this tool is it helps identify what your specific weaknesses and gaps are within your own facility. It’s very individualized,” Embree says. “Maybe one facility is showing some deficiencies in quality, maybe another facility is showing deficiencies in their health inspection areas. It just depends on where the weaknesses are within your facility.”

All the tools that Embree and Bulger will be sharing in their conference session are practical, low-cost, and high-impact.

“They really don't cost your facility much to implement, because you already have the resources there; it's just a question of discovering them,” says Bulger. “The process engages everyone, too. It engages your staff, it engages your residents, and it really builds towards a shifting culture that is more resident-focused.”

An example of one such tool is “shadowing”—an observation tool designed to help staff members connect directly with a resident’s particular experience from beginning to end. In “shadowing” a resident’s direct experience, you can more easily identify exactly where there’s a breakdown in quality, and be more efficient in taking steps to address it.

 

Example:

Oftentimes, says Bulger, the “shadowing” observation tool highlights a link between specific quality issues and breakdown in communication or coordination of care.

Let's say, for instance, the quality issue presented is dressing changes. Through this observation, you will identify the root cause and the key participants. Very quickly, you will be able to identify where the process is broken, and use that information to implement changes for improvement.

“It becomes more detailed as you dive deeper, because you're looking at the entire experience, and by doing so, you’re taking steps to move the entire experience to an ideal state,” says Bulger. “You’re following the resident, you're going to see the entire scope of care as it impacts that person, and you'll see the opportunities for change from their perspective. It's a renewable, self-improved, process-improved tool, that really gets the right people at the table.”

 

What else will I take away from this conference session?

Bulger and Embree will also cover other crucial components for you to consider as your facility prepares to make the move to value-based care, including:

  • Involving every member of your staff in helping to implement impactful changes in your facility.
  • Engaging with your residents to incorporate their voices into your facility’s policies and procedures, and to improve their overall experience.
  • Maintaining your quality improvements, once you’ve achieved them.

To learn more about the conference session, “Making the Move to Value-Based Care,” or to register for the conference, view our 2018 Conference page.

 


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