Value-Based Care payment models are based on a clear CMS goal: lower Total Cost of Care and its counterpart, Total Per Capita Cost. But neither TCoC nor TPCC gives you the information you need to target your cost efforts. How to start? Begin by evaluating what initiatives you need to do in the five key areas:
- Community Referrals
- Avoid High-Risk Events
- Cost Variation
- Chronic Disease Intervention
- Physician Episode Sharing
Your ACO may look at these five areas and think many of them are already underway through population health and other activities. But while population health efforts can help get patients services, they cannot change the course of treatments for patients who are not improving or evaluate variation in care. To make any clinical improvements in care, you will need to engage your physicians. Those physicians must be equipped with data that they trust.