Value-based care and the importance of RCM

Value-based care and the importance of RCM

Value-based care is a healthcare model that focuses on improving patients’ care through overall wellness and preventive treatments. It is a model in which hospitals, physicians, and healthcare providers are paid based on patient health outcomes. 

The value-based care model differs from the fee-for-service model. The unique feature of this model is that a patient need not pay for the number of healthcare services received. Instead, the patient can spend measuring health outcomes against the cost of delivering the results. 

Unlike the fee-for-service model, where the healthcare facilities are paid for the services they provided and procedures they performed on the patients, by insurance companies and government-affiliated organizations without checking if the systems or the benefits extended to the patients were really required or just performed to increase the billing, the value-based care model ensures that the clinics and physicians are reimbursed for the quality of service they provided with cost-efficient means.

The advantage of the value-based care model is that it takes an extensive approach to ensure that the physicians are rewarded for the quality of treatment they deliver to the patient at a lower cost.

Benefits of value-based care

Preventive healthcare is the core of the value-based healthcare model. It ensures that the patients undergo preventive health checks to identify the issues and getting the treatment much earlier before it becomes worse.

Through this approach, patients spend less money and achieve better health. For example, managing chronic diseases such as cancer, diabetes, high blood pressure can be expensive and time-consuming. Through a value-based care model, the patients can recover from illnesses more quickly and avoid chronic disease in the first place through preventive healthcare.

Some of the key benefits are –

  • Patients spending less to achieve better health
  • Providers earning efficiency in their business and greater patient satisfaction
  • Payers controlling costs and reduce risk through preventive healthcare
  • Suppliers aligning prices with patient outcomes

How does value-based healthcare translate to new delivery models?

The proliferation of value-based healthcare is changing the way physicians and hospitals provide care. New healthcare delivery models stress a team-oriented approach to patient care and sharing of patient data so that care is coordinated and outcomes can be measured easily.  

Future of value-based healthcare

While it is at a very nascent stage, value-based healthcare is receiving a lot of takers. The healthcare landscape continues to evolve, and as providers increase their adoption of value-based care models, they may take short-term financial setbacks, but they will surely see their costs decline in the longer run. 

Fee-for-service to fee-for-value transformation is slow but steady and is widely considered the best method to lower healthcare costs while increasing quality care and helping people lead healthier lives. 

Importance of RCM in value-based healthcare

Value-based care is a new world where the providers have to be accountable for reimbursement as the reimbursement is based on meeting high-quality measures and shared-risk of costs with patients.

Revenue Cycle Management (RCM) ensures value-based healthcare providers with fair and complete reimbursement for their care to patients. In the fee-for-service model, medical encounters are appropriately documented in the electronic health record (EHR), submit claims, and followed through to payment. 

With the value-based healthcare model, reimbursement is dependent on quality and cost performance. Therefore, the shift to value-based care requires providers to revisit their existing RCM approach.

iMagnum – the ideal partner for value-based healthcare providers 

iMagnum provides best-in-class Pre-billing services Post billing and offers Revenue improvement opportunities. We are an organization driven by passionate young leaders having end-end RCM experience for over two decades. Managing large-sized hospitals and physician groups like IPA’s, ACOs, Acute Care Hospital, and Large Physician Groups revenue cycle is our key competence.

The birth of iMagnum was an outcome of process hard-ships the hospitals, physician groups, and independent physician groups have to experience every day to get their reimbursement. We felt our clients deserve a much better experience to treat the patients at ease while iMagnum manages their End-End Revenue Cycle.

iMagnum vision is to build the process on Technology solutions that provides enhanced experience for our clients in terms of speed of delivery, quality, and most importantly, transparency and accountability with complete ownership of End – End Revenue Cycle.

So, what’s different at iMagnum:

  • Service Delivery at 2x speed with the industry-accepted Quality Standards
  • Guaranteed Outcome – Accountability of Cash Goals
  • Old AR Recovery – Commitment of Expected collections before signing the contract
  • Furthermore, the cost of having iMagnum as a partner is Cheaper

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