Value Based Care

According to a new study, over 94% of executives in healthcare anticipate value-based care contracts to become more expansive in the future. This means that the business model for home health and hospice agencies should be focused around offering more robust value based care initiatives and prioritizing health outcomes, coordinated care, and reducing any waste rather than simply increasing volume of patients.

New Value-Based Care Regulations to Be Released in 2022

New regulations regarding value based care will be released in 2022. After the Affordable Care Act was instituted, agencies began moving towards new value-based initiatives to promote better care rather than higher volume. The introduction of the Stark Law and then later the Anti-Kickback Statute prioritized a traditional fee-for-service model, which in some ways prevented agencies from fully transitioning to value based care. New regulations have been announced that will allow agencies to more fully transition to a value-based care model.

Creating a Value-Based Enterprise

Healthcare organizations, especially those involved in home health and hospice care, should focus on creating a value-based enterprise that prioritizes patient satisfaction and quality of care, which typically involves moving to a system which allows multiple providers to collaborate within a target population of patients. Within this system, these providers agree to collaborate as necessary to improve patient outcomes and provide the best standard of care possible.

It is important to closely evaluate the Stark exception when creating your value-based enterprise, because the regulations very clearly outline the permissible pathway to creating value-based care initiatives. Within home health and hospice care, the value-based model is quickly becoming the most logical path, since it allows multiple providers and caregivers to collaborate together to ensure each patient receives the best available care.

That being said, accommodations must be made to ensure not to violate the Stark law, which includes that participants must always have a good faith belief that the activities that they engage in lead to a positive value-based outcome for the patient. Ensuring a value-based purpose is just the tip of the iceberg in adhering to the regulations enacted with the Stark Law. More information on creating a value-based enterprise can be found at: https://www.jdsupra.com/legalnews/new-opportunities-in-value-based-care-1269230/.