AUSTIN, TEX. – Gathering data, seeking new partnerships, and showing leadership are the key ways to prepare for value-based medical practice, according to Houston-based health law attorney Ellie Bane.
“We are entering a whole new world in health care reimbursement,” Ms. Bane said at a conference held by the American Health Lawyers Association. “Physicians who think ahead will be well suited to succeed.”
Ellie Bane
If you don’t have practice data, start collecting the information today, she advised. Data – such as how long it takes for patients to book appointments, primary reasons for patient visits, and trends on care management – can set doctors apart and create leverage when it comes to new networks.
“You want to have reliable data so that when you go to partner with a health system or a health plan, you can show them what you can offer,” Ms. Bane said in an interview.
If the data do not exist, reach out to payers to see if they can help gather it, Ms. Bane suggested. Some health plans will assign a physician assistant or nurse practitioner to follow up with patients and help collect trend data. Other plans provide nurses or case managers to doctors who participate in certain initiatives such as quality, disease management, or performance improvement programs.
Demonstrating leadership also is key. Be vocal to hospitals and health plans about your interest in alternative payment systems and your desire to lead the transition, she advised. Be proactive by researching clinically-integrated networks, for example, and determining which network may work best for your practice.
“You want to become that value-based champion so that others will want to contract with your group,” she added.
When choosing a health system to partner with, assess whether the system is adequately responsive, can pull data in a timely manner, and can shift as measures change.
“Can your practice do the same thing?” Ms. Bane said. “If quality metrics change, are you able to change your systems to respond?”
Be creative and stay ahead of the curve by searching for novel ways to coordinate services and enlisting guidance, she said.
“A joint venture or Physician-Hospital Organization might have worked 5 years ago, but, it may not be the best model today,” she said. “This is where effective counsel is so helpful. A good health law attorney will be able to think of creative alignment strategies that will benefit the providers, health plans, systems, and – most importantly – patients.”
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