June 9, 2022
5 Keys to Successful Value-Based Care
VBC (Value-based care) was not on Dr. Rob Bessler’s mind when he founded Sound Physicians in 2001. Bessler was focused on another challenge – how could he get his emergency department patients admitted to the hospital when they didn’t have a physician to follow them? At the time, the field of “hospitalist” medicine was a new practice, with only a few thousand doctors working as hospitalists across the U.S.1 Dr. Bessler believed more of these doctors were needed – and he went on to build what is now the nation’s largest hospitalist program.
Today it’s hard for me to imagine hospitals without hospitalists, and even harder to imagine Sound Physicians without value-based care.
Knowing that 50% of Medicare costs happen during the time of admission through 90 days afterwards, it was obvious that Sound’s vision to be the leader at improving quality and lowering cost would be guided by driving great outcomes in the acute episode. Eight years ago, BPCI sharpened our focus and created an economic model that rewarded doing the right thing for patients. Our value-based initiatives led to a 26% reduction in 30-day readmissions, a 60% reduction in LTACH use, and a 31% reduction in SNF use for our BPCI patients.2 Our success with BPCI soon paved the way for Sound to become the single largest initiator of BPCIA episodes nationwide. In 2022, our VBC partners go well beyond CMS to include hospital ACO’s, physician groups, health systems, and payers like United Healthcare and Humana. Our secret sauce in VBC has been our ability to leverage one of our most valuable assets – our hospitalists – with extended hospitalist models that support a range of value-based integrations.
After many lessons learned and promises kept, we’ve established five key principles for a successful value-based care initiative:
- Align incentives and provider accountability for managing total episode cost
- Design purpose-built clinical workflows enabled by technology to drive repeatable results
- Increase clinical focus on patients most at-risk for adverse outcomes
- Performance-manage hospitalists, provide continuous oversight and real-time analytics
- Ensure a high level of collaboration with PCPs, post-acute providers, and plans
We’ve also learned that a one-size-fits-all approach will not work when it comes to value. Every market is different, every partner’s needs are unique, and forming flexible partnerships with models that can be customized to meet a community’s needs is paramount. To scale programs effectively, we must use telemedicine and other innovations to efficiently connect patients to hospitalists beyond the hospital’s four walls.
If you are interested in how we’ve put our principles into practice with extended hospitalist programs to ensure coordinated, high-value care throughout the entire patient episode, including post-discharge, I encourage you to watch this webinar hosted by Healthcare Exec Intelligence. First aired on May 5, 2022, you can now access the presentation on-demand.
- OLR Research Report, Connecticut General Assembly, 2008
- Sound BPCI Trend vs. National Non-Participating Hospitals (Medical Bundles Only)