Making Value-Based Care Work for Independent Cardiologists

The move to value-based care brings plenty of potential upsides for independent cardiologists. But to reap the full benefits, practices must know how to achieve appropriate scale and track the right metrics. 

CardioOne is an advocate for the transition to value-based care–we’ve recently spoken at the American College of Cardiology Value-Based Care Forum about the role independent cardiologists have on value-based care and earlier this year we hosted a webinar alongside MedAxiom discussing value-based reimbursement models and what it means for independent cardiologists in an evolving healthcare landscape. 

Defining Value-Based Care as a Continuum

Ideally, value-based care would be easily defined, implemented and monitored, but in reality it is not a one-size-fits-all approach. Value-based care is a continuum and as independent cardiologists move from payment-for-volume to payment-for-outcomes, their risks will increase, but so will their reward. 

Right now, most cardiology practices remain entrenched in payment-for-volume contracting models, whether it’s a traditional fee-for-service or pay-for-coordination model. Eventually, practices will move toward pay per performance. Then they will progress to bundled payments, shared risks, and eventually reach global payment capitalization, a super-sophisticated contracting model that’s considered the highest level of value-based care. To take on more risk at each step, providers must scale their resources to match the needs of the contract.

This shift may sound intimidating, but it’s important to know that it won’t happen all at once. Practices should expect a gradual transition into higher levels of value-based care payment, led by federal regulations and payers.

Where Independent Cardiologists Stand with Value-Based Care Today

Since their introduction in 2008, value-based care payment models have steadily been on the rise, moving from primary care and slowly trickling down to specialties such as nephrology and oncology. Today, value-based models are expected to grow across all specialties.

Cardiology currently has low value-based care adoption. However, the rapidly increasing cost and incidence of cardiovascular disease (CVD) will cause regulators and payers to incentivize independent cardiologists toward value-based contracting models.

Consider that CVD is already the leading cause of death in the U.S, making it a significant contributor of medical expenses. By 2060, the incidence of CVD is expected to increase by 30%. Combine all of this with an aging population, and it’s easy to see why value-based models will become a must-have. CVD costs are substantially higher than many other chronic conditions such as diabetes and Alzheimer’s. That’s why it’s so important to reward independent cardiologists for achieving better outcomes.

Adopting Value-Based Care in Practice

To be ready for tomorrow, successful independent cardiology practices, by necessity, will look different from yesterday’s. The fundamentals of value-based care adoption in practice include:

• Optimized practice operations that create streamlined workflows and better patient access
• Patient identification and analytics so practices can better understand their patient population and its associated risks
• Interventions and care management that are personalized to help patients reduce their risk for CVD
• Reporting and contracting so practices can track patients’ results and demonstrate outcomes

To achieve these fundamentals, the practice of the future must put the patient at the center, surrounded by the right technology, care teams, contracting and data. Doing so will help practices achieve the standardization and scale they’ll need to create consistent, high-quality treatment plans that deliver positive outcomes.

To be ready for tomorrow, successful independent cardiology practices, by necessity, will look different from yesterday’s.

As practices navigate this new landscape, they must:

• Know what to measure. It’s important to define success early and specifically by using established metrics (when possible). This involves sophisticated contract development, data analysis and patient coordination. 
• Find the right technology platform. Technology must be integrated. Having a platform that sits somewhere different than what you’re working in every day is not going to work.
• Choose the right partners who can provide clinical resources and support and deliver real results capable of dramatically improving your practices’ capabilities. 

Creating a Value-Based Infrastructure

Make no mistake, adopting value-based care is complex. That’s why independent cardiologists should leverage technology to their full advantage. Building a technology infrastructure that’s value-based-care ready requires deep involvement across a patient’s entire journey of care, even when they’re not in the office.

At a baseline, the right platform should give you tools to identify and risk-stratify patient cohorts. It also should offer you clinical decision support and population health management tools so that you can help your patients prevent CVD. And finally, a top-tier platform will give you patient activation and reporting tools to keep the lines of communication open and help you understand outcomes and follow-ups.

A value-based technology platform like CardioOne checks all the marks. It includes a best-in-class EHR, integrated with value-based cardiology tools—everything from Remote Patient Monitoring and population health analytics to payer relationship management and value-based contracting solutions. With CardioOne, you’ll have the tools you need to empower your practice and its care teams at every step of the value-based care continuum.

With CardioOne, you’ll have the tools you need to empower your practice and its care teams at every step of the value-based care continuum.

Build for Tomorrow

A value-based care future is on the horizon. Independent cardiologists can take a few steps to prepare today:

• Begin building out and testing your practice’s value-based capabilities.
• Stabilize and optimize current operations.
• Assemble the technology, care teams and contracts you’ll need to succeed in executing and reporting on key quality measures.
• Ease into value-based care by obtaining performance-based contracts instead of diving straight into risk.
• Start being a thoughtful partner to primary care providers.

You’ll ultimately need scale and leverage to succeed in value-based care arrangements, and being a part of a larger network is critical. As a private practice cardiologist, it’s challenging to be a part of a broader value-based contract. However, together, independent cardiologists are stronger and have the ability to enter into these types of arrangements as one entity.