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Each year, a growing number of providers are entering value-based care arrangements, including primary care providers (PCPs). Given their holistic view of patients, PCPs are the best types of clinicians to drive value-based care. Medicare’s Primary Care Transformation programs and many payer-developed value-based care contracts are proof of the move for PCPs to be at the center of this transformation and ultimately at the center of the care experience — right where they belong.
While the shift may be underway, many PCPs are not well prepared to operate successfully in these new arrangements. Currently, 67% of Humana’s Medicare Advantage members receive care from a PCP in a value-based care agreement. And yet, many PCPs remain in the dark when it comes to effective documentation, coding, and risk adjustment for their Medicare Advantage patients, all of which help drive value-based care outcomes, and income.
So how does a PCP take control of their value-based care success? One answer is accurate assessment and reporting of a patient’s clinical needs so that value-based payments will align with the necessary care delivered to that individual. By making documentation and coding activities a physician-driven priority in their practices, PCPs can receive the payments they need to close care gaps, leading to better outcomes and ultimately value-based care success.