Opportunity via Changing the Payment Model
Although clinicians often begin care model design with the
intent of implementing clinical practice guidelines, the care
models bend to reflect reimbursement models. Despite providers’ and health systems’ fears about the often unknown
financial risk and increased burden with new payment models, the growth in these models should be embraced as an
opportunity to redesign the care model to deliver better value.
Health care delivery now mirrors other industries: the more
risk assumed, the greater the opportunity for financial reward
and those who lead change will most likely benefit compared
with those who follow.
No time is better than the present for providers to proactively and voluntarily initiate new payment models in the
primary care of LBP. Providers who trust their ability to deliver
evidence-based care, have strong clinical judgement and can
create high performing teams, should willingly accept accountability for their clinical outcomes and assume financial
risk. The more transformational the reimbursement model, the
more liberated providers will be in designing the care model.
Under population reimbursement models, clinicians can
integrate high-value LBP interventions that are not well compensated in the current heavy fee-for-service environment,
like group exercise, meditation and health coaching. With
increased flexibility in reimbursement and large opportunities
to reduce cost to deliver care, strategies that reduce unnecessary care through improved care coordination, data analysis
and prevention can more easily be resourced. By initiating
payment efforts, providers can maintain a leadership role
in defining the care model, rather than having best-practice
care be shaped or diluted by payer reimbursement models.
Payment reform should not be feared. It is an opportunity for
leaders to rise and be financially rewarded for delivering value.
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Back Pain? Make Sure You and Your Spine
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