Helping Value-Based Care Delivery Pay for Itself

by Robert J. Fortini, VP and Chief Clinical Officer, Bon Secours Medical Group

Although many commercial health plan payments now focus on value rather than volume, the bulk of physician income is still derived from fee-for-service payments—or, for employed physicians, salary plus production incentives.a

Pioneers of value-based payment arrangements must navigate this reality if they are going to safely steer their fiscal ships through the choppy waters of healthcare reform. While investing in population health management, these healthcare organizations should seek revenue streams to cover the cost of new infrastructure requirements and to bolster provider income until all or most payments are value-based. To this end, investing in care managers and health IT may generate additional fee-for-service income.

We have put these approaches into practice at Bon Secours Virginia Medical Group (BSVMG), a 600-physician, hospital-affiliated, multispecialty group based in Richmond, Va. To support our patient centered medical homes (PCMHs) and our accountable care organization (ACO), we hired nurse care managers to improve care coordination for our high-risk patients

and also expanded our health IT infrastructure. Several new revenue streams—some of them volume-based—have generated nearly twice the amount of money we have spent on care managers...

Template not found

The above article originally appeared in the January 2015 issue of HFM Magazine