Succeeding in Value-Based Care: Part 1

An Integrated Approach to Value-Based Care Governance for Healthcare Providers

Summary: The cultural shift to value-based care hinges on individuals’ engagement, willingness to adapt, commitment to the project’s goals, and understanding of the need for change. By involving physicians, aligning goals, communicating effectively, and measuring progress, organizations can establish a framework for sustained success. 

Welcome to the first post in our series on transforming healthcare operations to succeed in the rapidly growing environment of value-based care. This series will explore some of the complexities of shifting to value-based delivery models, the challenges they can present, and the strategies to help overcome them. Establishing an overarching strategy that includes program governance, a focus on change management, and generating buy-in from your front-line staff is an important first step.  

Large-scale transformation projects in healthcare, such as transitioning to value-based care, involve numerous priorities, from upgrading technology and hardware, to hiring and training staff, to developing comprehensive project plans. However, one critical aspect often overlooked or under-resourced is the cultural shift necessary for any initiative to succeed:

Transitioning to a value-based care model that focuses on quality of care and patient outcomes requires a profound culture change within any organization accustomed to a fee-for-service model. 

The success of this transition hinges on individuals’ engagement, willingness to adapt, commitment to the project’s goals, and understanding of the need for change. Physicians and other providers, whose roles are pivotal in value-based care success, are at the forefront of this shift. 

Below is a three-pronged approach to keeping the individual in mind as you manage this transition.

1.Engage With Physicians Early and Often 

Start With the Why: Developing a set of guiding principles is crucial. These principles will guide the organization during the decision-making process and ensure the overarching vision is achieved. Facilitating these discussions with stakeholders from all areas of the organization helps clarify and focus the vision. 

Engage Physicians: Physician leadership and support are critical for a successful transition. Engaging physicians early, inviting them to join committees, and allowing them to take a leading role in planning fosters buy-in and commitment. Data suggests engaged physicians are more productive, and patients under their care experience better outcomes. 

Align With Physicians’ Goals: Aligning organizational goals with those of physicians encourages them to take responsibility for the organization’s objectives, leading to a more realistic and achievable strategy for value-based care. Physician-led initiatives are more successful at creating a sustainable impact on outcomes than top-down governmental regulations. 

2. Educate on the What and the Why in Addition to the How 

Define Value-Based Care: Despite its being a buzzword in healthcare, each organization needs to define value-based care. Establishing a clear vision and guiding principles enables effective communication throughout the organization. 

Educate on the Benefits: Change is challenging, but individuals are more receptive when they understand its necessity and benefits. Effective communication that builds awareness and encourages the desire for change is crucial. 

Deliver Practical Training: Beyond initial training, sustainable change requires ongoing education and engagement. Clear, step-by-step processes and regular updates ensure all stakeholders feel prepared and confident in their roles. 

3. Set Goals and Share Them 

Define Success: It is vital to clearly define success metrics and communicate these goals. Everyone in the organization should understand what you are measuring and why. 

Deliver Data Transparently: Progress toward goals should be easily accessible and understandable. Sharing metrics and data through tools like scorecards or dashboards helps maintain focus and motivation. 

Transitioning to value-based care is a complex but essential journey for improving patient outcomes and reducing healthcare costs. Establishing a robust governance and change management structure is a critical first step. By engaging physicians, aligning goals, communicating effectively, and measuring progress, organizations can create a framework for sustained success. 

In our next post, we will explore specific strategies for integrating external data and generating real-time, individualized insights for your providers. Stay tuned as we examine the pathways to a more effective, patient-centered healthcare system.