Evaluating a specific value-based contract requires weighing the potential benefits and risks related to the organization’s capabilities and resources, the financial impact, and credit risk. Physician engagement, transparency and accountability, and performance measurement and improvement all must be in place for a value-based contract to be successfully implemented. We provide the expertise and in-depth understanding of contracting dynamics to ensure success. Value-Based Contracting is what we do!
Healthcare can be confusing, especially when trends change rapidly with advancements in science and technology and government regulations.
In a value-based system, providers, hospitals, and physicians are paid based on their patient’s health outcomes, rather than how many patients they see or how many hours they log. Health outcomes are measured in factors such as improvement in overall health, reduced diagnoses of chronic diseases and the ability to live independently at home.
The Aging Wave:
The Census Bureau projects that in 2034, for the first time, people 65 and older will outnumber those under 18. Additionally, Medicare enrollment is expected to increase by nearly 50 percent, rising from 54 million today to more than 80 million in 2030. This aging wave creates multiple ripples, starting with the healthcare needs of seniors who are increasingly living with one or more chronic condition that requires long-term care in a healthcare facility or at home. It also impacts spouses or adult children who take on the often-full-time role of providing or coordinating care, which can leave them facing caregiver burnout as they continue to work or raise their children.
We’ve been hearing about designing green for years to make sure facilities are energy efficient and cost-effective. However, adults over the age of 74 had the highest rate of hospital stays in 2014, followed by people in their late 60s and early 70s, so it makes a great deal of sense to shift to what is being referred to as “silver architecture.” These designs help improve quality of life and independence for an aging population and are well-lit, quiet, accessible and safe to navigate for assistive devices like wheelchairs and walkers.
Studies show that people who are more involved in decisions about their care plan see better health outcomes. However, these people are generally more satisfied with their care as well, which can be a significant advantage to healthcare providers who rely on online reviews to inform potential patients and families to choose care with them. In 2019, expect to see more engagement programs, apps and technology, and health literacy initiatives that aim to educate people on their condition and care.
How to act like a respected leader?
Not sharing how we’ve failed (and talking up our accomplishments too much) triggers something decidedly not good in peers.
This envy creates dysfunctional behavior as peers, or even direct reports, seek to tear down and undermine the successful leader. It also causes employees to behave less and disrupts a sense of teamwork.
Obtaining respect as a leader is difficult enough to accomplish. So why would we jeopardize it once we reach it? Unwittingly we do just that when we withhold or try to bury one thing about ourselves in particular–our failures.
When an employee hears a leader talking about their mistakes, it can induce empathy where the employees feel that the leader deserves their success, and they feel inspired to improve their performance. So there’s a better way forward than burying your blemishes.
What does it mean to be a respected leader?
If you’re highly successful, your achievements are apparent. It’s more novel and inspiring for others to learn about your mistakes. What’s exciting about this is that we’re trying to chip away at the resentment that comes with envy and move people toward admiration instead. One way to do that is to acknowledge your struggles or shortcomings.
Raise your hand if you’d prefer admiration over envy?
When planning your career growth in healthcare, you’ve likely considered the best education options. The skill set you learn to work as a physician, nurse, or any type of support staff in healthcare is understandably a high priority.
We often spend so much time considering the type of training and level of references we need to advance, that we don’t consider the soft skills that are also important for a long-lasting career. Whether you work in a small practice or a large hospital, there are high stakes involved in your day to day responsibilities. Healthcare workers can deal with long schedules and a much more stressful work environment than other types of professionals.
Developing the personal skills necessary to succeed in the field will not only make you a better employee but will help you find a balance between your work and personal life.
5 Personal Skills You Need in Healthcare
The technical skills you need to succeed in your position are only part of the equation. These five personal skills are essential to your continued career growth in healthcare:
- Empathy. Of course, empathy will help your interpersonal skills, regardless of your profession. In healthcare, though, you’re often dealing with people at their most vulnerable. Because you see a wide range of health issues, it can sometimes be hard to remember to put yourself in the patient’s shoes. When they’re concerned over what you know to be a moderate illness, you might be tempted to overlook their worries. To give your patients the best tools and experience possible, always try to remember that they don’t have the healthcare background that you do. Try to remember how scary and frustrating it can be to not have control of your health issues. Empathy will also serve you well in dealing with coworkers and other staff members. Healthcare is very much a team environment. Understanding goes a long way to developing good relationships.
- Communication Skills. Communication is essential in dealing with the different facets of your position. It’s important that you’re clear in any notes or written communications, especially when they deal with the treatment of a patient. It also serves you well to be able to speak with patients and coworkers in a clear and pleasant manner to avoid misunderstandings and help facilitate a productive environment.
- Dedication and Work Ethic. In other industries, workers often have fixed hours with set breaks and lunchtimes. They are asked in advance if they’d like to work overtime and can plan on leaving their job at a set time every day. Healthcare workers, however, often forego lunch and breaks and will sometimes work exceptionally long hours with little notice. Most healthcare workers love what they do and are dedicated to each patient and case that they see during their day.
- The Ability to Deal with High-Pressure Situations. Mistakes in healthcare can have extremely high consequences. Outcomes aren’t guaranteed even when you follow the best practices for a give situation. This makes for a very high-pressure situation which can be exacerbated by outside influences, such as family and the patient. Many people who do well in healthcare careers thrive on the high stake’s nature of the job. They do well under pressure and can make split-second decisions without second-guessing themselves.
- Life Long Learning. The phrase, “there’s nothing new under the sun” does not apply in healthcare. There are always new techniques and procedures available. Even in specialties that don’t see a lot of change, you have to be able to adapt to other physician’s processes and to be able to take critique well. The focus is on providing the best possible care. A good healthcare professional leaves their ego at the door and embraces every opportunity to learn new skills.
Whether you’ve been in the industry for many years or are just starting out, improving these five soft skills will help you build a longer, more successful career in your field.
What is a Medicare Advantage plan?
If you are under the original Medicare (Part A and Part B), you might have an option to get your Medicare coverage in another way through a Medicare Advantage plan, offered by Medicare-approved private companies. Medicare Advantage plans must cover everything federal Medicare covers except for Hospice care which is still covered by original Medicare Part A. Some MA plans may offer some extra benefits, such as routine vision care, routine dental care, and prescription drug coverage. With Medicare Advantage insurance you must pay your part B premium.
How much are my Medicare Advantage premiums?
If you do have a Medicare Advantage plan, you most likely are paying two premiums: Your Medicare Part B premium and an additional premium charged by the private insurance company that administers your plan. The MA premium amount will vary from plan to plan. Some MA plans offer a zero monthly premium, but most likely you won’t be able to get out of paying your Part B premium. The standard Part B premium for 2018 is $134 monthly roughly.
What is a tax deduction?
If you meet the criteria set by the Internal Revenue Service you may be eligible get a tax deduction and your premiums paid for Medicare Advantage plans. The IRS states you can subtract your tax deductions from your income before calculating the amount of tax you owe. The more deductions you have, the less you might owe in taxes. For more frequently asked questions when it comes to healthcare, please view our FAQ page.
How can I get a tax deduction for my Medicare Advantage premiums?
When you are filing your taxes with the IRS, you have a choice to take the standard deduction or itemize your tax deductions. To get a tax break or deduction for your Medicare Advantage premium or Medicare Part B premium, you must itemize your tax deductions. The Internal Revenue states that you can deduct certain medical and dental expenses for yourself if you itemize deductions on schedule a form 1040. The IRS has a long list of what is accepted and not excepted items under the category of medical and dental expenses. The one piece you might be able to include is medical and hospital insurance premiums, which might consist of your MA premiums.
There are income limitations on itemizing tax deduction. According to the Internal Revenue services website, you may not be able to deduct all your itemized deductions if your adjusted gross income is more than a certain amount. Check with the Internal Revenue Service or talk to a tax preparer for details.
This article should not be relied on for tax advice, and please consult a tax advisor who understands your particular circumstances to see what, if any, part of your medical expenses may be tax deductible.
I believe that only about one-fifth of doctors have recently started providing ancillary services.
But as the squeeze on physicians’ reimbursements continues, interest in ancillary services has been increasing and interest varies widely by specialty. PCPs, in particular, have a wide range of ancillary services to choose from. Family physicians listed medication dispensing, weight-loss services, in-office diagnostic tests, nutrition counseling, cosmetic services, and alternative treatments such as acupuncture and massage.
What is managed care contracting?
Managed care contracting are contracts which attempt to restrain healthcare costs by controlling both the quality and the type of services provided. The level of service and cost are both considered with managed care contracting. There are three basic types of managed care health insurance plans: (1) HMOs, (2) POS plans, and (3) PPOs.
What is payment model?
A payment model is a methodology developed by payers for health care services. Currently in 2018 the payers are moving away from FFS (fee for service) volume driven services to instead a value driven model. This transformation includes an incentive for providers on cost, outcomes as well as quality.