How to Set Clear Goals for Value-Based Care Success

Welcome to part-two of our three-part series on how to implement value-based care (VBC). Phase Two translates the insights gained from the assessment in Phase One into actionable objectives that will guide your transition to value-based care. By setting specific success metrics including financial goals and improvement targets, you lay the groundwork for a strategic approach to value-based care. The focus will be on enhancing care coordination, preventive care, and chronic disease management, while leveraging technology and data analytics to drive continuous improvement. Additionally, this phase will involve defining the necessary training and development goals to ensure that your staff is fully equipped and motivated to embrace the transition. When you set clear goals for value-based care success, your organization can navigate the complexities of value-based care with a focused and coherent strategy.

As you set out to establish goals that will help you track and measure your success in value-based payment models, it’s important to do so in the context of your organization’s mission and vision. An important aspect of change management of any kind is to be able to communicate how the change aligns with the organization’s mission and vision. It’s also critical to establish feedback mechanisms that allow for ongoing evaluation of value-based care initiatives, gather input from patients, staff, and other stakeholders to ensure that the organization remains responsive to changing needs and challenges.

In our recent blog, Value Based Payment Models: 5 Key Strategies for Success, we talked about some key initiatives that will enable success. In order to fully capitalize on these and your other value-based initiatives, it’s important to establish detailed key performance indicators (KPIs) that will measure progress toward value-based care goals. For example, leverage surveys to measure patient satisfaction, ensure you’re on top of care gaps and opportunities for preventive care, and track your care management initiatives for patients with chronic conditions and those discharged from the hospital.

Your KPIs should be realistic, achievable, and aligned with industry standards. A process should also be established to regularly review progress with all stakeholders. Transparency is key.

Understanding the cost of care delivery is essential to managing risk under value-based payment models. This involves tracking expenses, from staffing and supplies to rent and utilities. Next, determine cash reserves that will be needed and start building towards that goal. In parallel, explore financial products and services designed for healthcare providers, such as lines of credit or revenue-based financing to cover potential shortfalls during the transition to value-based care. Implement strategies to accelerate revenue collection, such as patient payment plans and electronic payments. Set goals for the expected impact of those strategies, and track your progress. You should also consider identifying opportunities to reduce costs without compromising patient care, such as renegotiating supplier contracts or optimizing staffing levels.

Rewarding your providers and staff for achieving specific quality metrics and cost-saving benchmarks will go a long way towards driving the behavior and activities required for success. Examples of rewards include performance-based pay, shared savings, and gain-sharing

Improving care coordination takes a multi-pronged approach that includes people and technology. First and foremost, your organization has to adopt a patient-centric approach to care. The key to achieving this is via a multidisciplinary team culture and patient empowerment. To foster a team culture, schedule regular team meetings to discuss patient cases, share information, and address challenges. Empower your patients through education, self-management tools like remote monitoring and patient portals, and include them in shared decision making. From a technology standpoint, seamless data sharing cross functionally, with the patient, and with a network of high-value specialists is critical. Make sure your core operational systems have the ability to integrate quickly with third-party solutions and other health IT systems.

Prioritizing preventive care and chronic care management are critical to success under value-based payment models. Examples of target measurements include:

• Increasing the percentage of patients receiving recommended preventive screenings (e.g., mammograms, colonoscopies).
• Reducing the incidence of preventable hospitalizations for chronic conditions (e.g., heart failure, diabetes).
• Improving blood pressure control rates for hypertensive patients.
• Increasing the number of patients engaged in wellness programs.

Transitioning from a fee-for-service to value-based care delivery and reimbursement model requires a strategic healthcare technology roadmap. The roadmap serves as a guide for decision-making, prioritizing technology investments, and ensuring that the right tools and systems are implemented to support and track both clinical and operational goals. Below is a list of questions that can help when conducting due diligence with potential vendors:

1. Can you provide case studies or references from similar organizations that have successfully implemented your technology in a value-based care model?
2. How does your technology handle data interoperability, and what standards do you support?
3. What is your product roadmap, and how does it align with the future of value-based care?
4. What training and support do you offer post-implementation?
5. How do you ensure the security and compliance of your technology?
6. What is the typical implementation timeline, and what resources will be required from our team?
7. How do you measure the success of your technology in a value-based care setting? Inquire about the metrics and KPIs that the vendor uses to demonstrate the effectiveness of their solution in supporting value-based care.
8. What are the hidden costs or potential challenges associated with your technology? Be aware of any additional costs or potential issues that might arise during implementation and ongoing use.

Engaging and training staff on the technology necessary to support a value-based care initiative is crucial for success. To start, it’s important to foster a culture of continuous learning where staff are encouraged and motivated to adapt to new technologies. Providing comprehensive and ongoing training is essential, ensuring that all team members, from clinicians to administrative staff, understand how to use the technology effectively. Training should be tailored to the specific roles and responsibilities of the staff, focusing on how the technology can enhance their daily tasks and contribute to overall patient care. Additionally, it’s important to offer support resources, such as help desks, user guides, and peer mentoring, to help staff navigate challenges and build confidence in using new tools. Involving staff early in the technology selection and implementation process can also increase buy-in and reduce resistance to change, as they feel a sense of ownership and understand the direct benefits to their work and patient outcomes. Regular feedback loops should be established, allowing staff to share their experiences and suggest improvements, ensuring that the technology evolves to meet their needs and enhances the value-based care initiative.

In summary, set clear goals for value-based care success in order to assess the long-term impact of your value-based initiatives. Incorporate the following elements into the goals:

• Key Performance Indicators (KPIs): Monitor relevant metrics such as hospitalization rates, emergency department visits, and mortality rates.
• Patient-Reported Outcomes (PROs): Collect patient feedback on quality of life and satisfaction.
• Cost Analysis: Evaluate the financial impact of preventive and chronic care programs.
• Care Coordination: Track your progress, both internally and externally.
• Prevention and Care Management: Measure both the actual vs goal and the impact of these programs.
• Comparative Effectiveness Research: Compare outcomes with similar organizations or national benchmarks.

As you continue your journey towards implementing value-based care, it’s time to move forward with Phase Three. In the final installment of our series, we’ll guide you through the practical steps such as how to choose the right partners, negotiate contracts, and ensure a smooth transition. Don’t miss out on the final phase of your value-based care transformation—click here to read the third blog in our series and take the next step toward delivering better care at lower costs.