Public Program Payments Transition To Value Based

Home Care Path is actively participating in the National transition to a value based reimbursement model.  Large insurance plans managing Medicare and Medicaid funds are dependent upon an effective integration of service being performed around the beneficiary.

The shift moves providers efforts from "how much" to "how well".   Outcome tied reimbursement will require an adjustment of contracted assignment.  This is a part of stalling the growing administrative costs providers are experiencing.

As public funded benefit delivery minimizes reimbursement for chronic conditions that analysis identifies as a collaborative piece of repetitive tasks of care- measures of quality have a greater dependence upon integration.

Integrating delivery being performed around the beneficiary will require claims processing to apply the claims completion methodology upgrades to best meet these stronger fiduciary standards.  Simply put, value based reimbursement is about creating a much more responsive group of services.

To construct a more responsive network of integrated provision that supports care in the home setting the internal functions have to change to more efficiently conduct the tasks that foster delivery for a larger population.  The evaluative practice in this new value based style of delivery will be a comprehensive start to end ongoing review of how these internal departments are functioning to best support the providers efforts to meet the agreed upon outcome. 

With building a provider community capable of contributing to the success of this new model expect the regulatory authority (Department of Health Services) to define a claims completion percentage near 100 percent with in the contracts. 

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