5 Tips to Win at Value Based Purchasing

Value based purchasing is already the reality in many states—and potentially on the horizon for the rest.

For the states currently involved in the value based purchasing pilot, it’s a seismic change—and the stakes are high—but there are ways to manage the transition successfully, according to panelists participating in a July 20 Home Health Care News webinar sponsored by Homecare Homebase.

Value based purchasing, which is currently being piloted in nine states, ties Medicare payments to performance on quality measures. The panelists outlined a five-step approach to winning the value based purchasing game:


1. Educate—The home health industry, in general, has done a poor job educating people on the concept of value based purchasing, said panelist Mike Dordick, executive vice president at health care consulting firm McBee Associates, based in the Philadelphia area.

Quite simply, everybody in the industry should understand what value based purchasing is, he stressed. This includes clinical staff, back office staff, finance staff and billing staff—everybody.

“Even if you’re not in a value based purchasing state, it’s important for staff to just have a general idea of what’s happening with this proposed pilot and the rule overall,” Dordick said. “That’s absolutely No. 1.”


Individual home health agencies should also have data analysts if possible, according to panelist Kate Jones, senior vice president of public policy and research at Baton Rouge, Louisiana-based home health and hospice giant Amedisys, Inc. (Nasdaq: AMED).

“Even if an agency doesn’t have [a data analyst] as a stand-alone role, there should be someone whose job it is to understand how the value based purchasing model is structured,” Jones said. That person could, conceivably, serve as a point person when other employee have questions.

2. Analyze and prioritize—“Nobody can work on improving every measure simultaneously,” Jones said. Start with process measures, she advised, and be sure to create a playbook with improvement strategies for each of the measures.

Similarly, agencies should set specific goals and measure each of the goals’ eventual success, panelist Scott Pattillo, vice president of product management at Homecare Homebase, advised. Achievements that result from these goals should be celebrated, but then agencies should move forward in pursuit of tackling the next goals, he said.

Additionally, it’s wise to focus on measures that are easier to fix first, rather than start with a measure that will take longer to fix.

“Don’t start with a process measure where you’re 20 points behind,” said panelist Luke James, chief strategy officer for Dallas-based Encompass Home Health & Hospice. “That’s not something that you’re going to be able to turn around overnight.”

Also, make sure you are first and foremost analyzing your own data, Dordick stressed—not worrying about the status of your competition.

“You need to know where the competition is, but don’t worry about them—just have an idea,” Dordick said.

3. Engage your staff—“Let’s face it, value based purchasing is a competitive environment,” Jones said. It’s critical to have an engaged staff that is committed to helping your organization succeed.

To succeed, Amedisys encourages “friendly competition” among staff members.

The agency directors use bulletin boards for recognition, and they celebrate successes to generate staff enthusiasm around this effort, Jones said.

4. Use what tools you have at your disposal, and add to your tool kit—Be sure to quantify your progress, Jones said.

“You can use your own reporting capabilities, as well as data from [companies such as] Homecare Homebase to help quantify your progress,” Jones said. Agencies should determine if what they’re doing today in real time will have an impact on the results when they’re eventually published.

“We try to predict where we’re going, instead of looking at where we’ve been,” Jones said.

5. Stay engaged with the information available from the Center for Medicare & Medicaid Innovation (CMMI)—Participate in all of CMMI’s education sessions, and generally stay in the loop on what’s happening, Jones advised.

“Keep [value based purchasing] top of mind as something that you’re working on all the time,” she said.

Remember, any program a home health company puts in place to prepare for value based purchasing is going to be beneficial, Pattillo said.

“It’s not going to be wasted time,” he said. “Certainly looking at ways to improve your standing in all of those different scores is time well spent.”

Written by Mary Kate Nelson

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