What is Value-Based Reimbursement & How Can Doctors Succeed?

March 05, 2018

What is Value-Based Reimbursement?

Although value-based reimbursement is a complex subject, the end goal is straight-forward: rewarding providers for the quality of care provided, versus the number and type of procedures. In short, value-based reimbursement promotes ways to change clinician behavior by rewarding value over volume.

The Medicare program is leading the charge by testing new payment and delivery models that address issues related to quality, cost, and inefficiency. For doctors, participating in one of these models comes at a cost – increased administration and reporting requirements on top of day-to-day patient care demands.

How Can Doctors Succeed?

Telligen is working to address these challenges by providing direct technical assistance and support to physicians navigating the transition to value-based care.

“We place a high-priority on supporting physicians by reducing their burdens,” said Jennifer Brotherson, Director of Information Management. “We want to let doctors be doctors so they can focus on providing the best possible care to their patients.”

For Jennifer’s team, this work started in 2012 with the Comprehensive Primary Care initiative, a four-year multi-payer program designed to strengthen primary care. Telligen’s CPC team provided centralized support to 500 practices across seven geographic regions, guiding the efforts of 2,144 providers.

Despite the learning curve that comes with a new program, CMS reported no increase in physician burnout among CPC participants. In fact, most chose to participate in the follow-up program, Comprehensive Primary Care Plus.

This follow-up CPC+ will be the largest-ever CMS initiative to improve primary care delivery and includes 5,000 additional practices. Telligen continues its role of providing centralized support for this scaled-up version of CPC. For CPC+, Telligen helps practices calculate monthly care management fees, comprehensive primary care, and incentive payments; as well as support analyzing and reporting quality measures.

“Our services go beyond that of a traditional call center to more of a concierge-type service built around one-on-one relationships,” says Brotherson. “These value-based models are the future of healthcare, and we expect support needs to increase as providers bear more financial responsibility for their care. We want to reduce their burden by delivering a seamless journey from the first call to every additional touch point. This, in turn, will free up their time to deliver better, more coordinated care.”

What Providers are Saying:

Gotta tell you that I’ve been on the phone with CPC+ support a few times and you guys have all been awesome. This is the most pleasant experience I have had with a federal government organization.
– Rich M. – Practice Caller

Telligen’s on-site project management staff are stellar and integral to the day-to-day functioning of the team. They anticipate our needs, maintain and update required documentation, and keep us organized, all while being extremely pleasant to work with.
– Provider Feedback from CMS CPARS Evaluation

Telligen and our team developed a close working relationship to implement the Quality reporting aspect of the model and we relied on Telligen’s knowledge and expertise to help us execute, including during an internal staff transition.
– Practice Feedback from CMS CPARS Evaluation

Telligen are focused on us as the client. Their staff are great to work with; knowledgeable, professional, pleasant. Personnel qualifications are matched to the role.
– Practice Feedback from CMS CPARS Evaluation

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