Working on Value Based Care and Fee For Service at the Same Time

While at MGMA I had a chance to sit down with Mike Hofmeister, Vice President of Value-Based & Community Solutions at Allscripts, to talk about Allscripts’ Chronic Care Management (CCM) and other value based care efforts. Coming out of MGMA I’d say that Chronic Care Management (CCM) was one of the biggest topics people were talking about.

What’s a bit unique about CCM is that it’s a hybrid of value based care in a fee for service world. In fact, when I asked Mike about how Allscripts was balancing value based care with fee for service he told me that they were looking at opportunities to implement processes, procedures, and workflows that benefited both value based care and fee for service.

I found this to be an incredible insight into the path forward for those of us trying to figure out how to navigate this new value based reimbursement world. No doubt there are plenty of efforts that can satisfy both sides of the equation. The reality is that we can’t just flip the value based care switch on and the fee for service switch off. We’re going to be living in a hybrid reimbursement world for a long time to come.

Mike also told me about how Allscripts was well positioned to help with doctor’s CCM efforts because at the core of the CCM program is access to healthcare data, analytics capabilities, and call center capabilities to follow up with the patients. Sure, there are a few more details to the program, but Mike is right that CCM requires the right healthcare data, data processing, and the right patient follow up procedures. For many patients a phone call is still the best follow up procedure. Although, I’m still interested to see how quickly this switches over to secure text from phone calls.

What seems clear to me is that most provider organizations aren’t going to take part in CCM on their own. A few larger ones will try it, but most provider organizations will be looking to an outside company to help them participate in the CCM program together with a larger group of providers.

Of course, we also have to realize that CCM is just the start. The companies that deliver great CCM solutions will be well positioned to deliver on future value based care programs. They’ll just want to make sure that they balance their value based care work together with the ongoing fee for service world.

About the author

John Lynn

John Lynn is the Founder of HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

   

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