value-based payment model

The reimbursement conversation is well under way at the water cooler among clinicians and healthcare execs, and for good reason.  The  Centers for Medicare and Medicaid Services plan to have 55 percent of all fee-for-service (FFS) payments replaced by a value-based payment (VBP) model by the end of 2016.  The reason for the switch?  Improved quality of care for patients, and less focus on the quantity of services provided as means for reimbursement.

Maybe it hasn’t been a quick or easy transition – you might even still be in the experimentation phase.  Here is the reality of it all:

  • If you haven’t made the switch, you’re not alone – More than half of all U.S. hospitals still haven’t, according to a study by Peer60.

You might be scrambling for ways to innovate in order to improve quality metrics and avoid penalties, but the good news is that four years into the program more hospitals are receiving incentives rather than losing money.

With this in mind, we believe mobile apps and disruptive technologies will continue to be a focus for providers as they make the switch.  Continuing to improve outcomes, efficiencies, and patient experiences without introducing better tech to patients is simply a recipe for failure.  Here are three areas to watch, and what providers can do right now with the resources they have:

Wearables – A Novelty or Practical Solution?

The role that wearables will play in a clinical setting is anyone’s guess, considering challenges that exist with FDA clearance and the lack of medical-grade technology in a largely consumer-driven market.  As far as the Apple Watch goes, Apple CEO Tim Cook admitted that even they “don’t want to put the Watch through the Food and Drug Administration process” just yet.

Many are still predicting wearables can improve quality of care and will be fueled by incentives or subsidies, despite skeptics that currently view them more as a novelty.  There is some progress being made, however.

  • Gartner predicts by 2020, 25 percent of wearable devices will be sold to insurance providers, employers, even weight loss clinics – not just retailers enticing us with glitz and glam.  What devices will have a chance to be accepted by the medical community and become mainstream? Only time will tell.

Download The eBook: Apps and Wearables in Healthcare – What Works?

Electronic Health Records

EHRs were mentioned as a way to improve outcomes at the World Health Care Congress 2016 – but at the moment, not everyone is on board with their effectiveness.  Senior policy advisor Robb Walton had this to say:

“Surveys show that they

[EHRs] are the leading cause of physician dissatisfaction. Many doctors say they are not worth it and that patient care is worse since the meaningful use program was [launched]. They spend less time in direct patient care than they do in clicking boxes on computers.”

What’s promising is that hospitals have now achieved a 96 percent  adoption rate for EHRs according to the ONC.

So the problem isn’t with adoption, but rather how data will be used and reported on over time.  Some like Robert M. Rowley, MD suggest a universal data platform is needed – something that current EHRs simply weren’t designed for in the fee-for-service model.

The Role of Mobile in a Value-Based Payment Model

Regardless of how data is collected and acted on in the future, apps are here to stay.  Many top hospitals have created at least one mobile app, but research suggests engagement rates are very low.

  • A recent Accenture study indicates that functionality is lacking, and patients just aren’t being given a good enough reason to keep them on their smartphones.

A key will be creating apps patients will continue to use – critical to proving a return on investment.    It’s not just about pouring resources into a single app after months of planning, but providing multiple apps with simple functions, like reminding  a patient of upcoming appointments , or allowing patients to set up medication reminders, for example.

We’re hearing first-hand about these challenges from some of the largest healthcare providers in the country, who are looking for solutions. We believe apps are the most practical route for  those focused on key performance measures in a value-based model, like  reducing 90-day readmissions. Technology is needed, but budgets are tight and custom development is expensive.

The MobileSmith platform makes it more affordable than ever to prioritize mobile innovation in-house, without the cost of mobile developers.  As providers switch to a value-based care model, we see apps as a perfect medium to improve outcomes among multiple patient groups.