Hans Morefield, Vice President, Population Health & Care Coordination, chatted with Joe Lavelle from IntrepidNOW at HIMSS17 to discuss the topics of value-based reimbursement and care management. Below is an excerpt from the interview:
“The old model was really simple, it was just volume based reimbursement. The more you did, the more you got paid. And that’s an expensive model for our industry and for our country, it’s an expensive model for employers, it’s an expensive model for patients. And so really it’s been in the works for 10 years or more that there’s a shift in the industry to say, well, let’s not reward volume let’s reward outcome, and so it used to be hospitals were, hey! Get the patients in, get them out and we get paid based upon how much they’re here, and if the patient went home and then came back to the hospital two days later because they weren’t recovering well, actually the hospital got paid again.
…one of the ideas that hospitals have is they have new incentives around what happens after you leave. Well they’re getting discharged from the hospital they’re going home, and the truth is when patients leave the hospital they’re not ready to go run a marathon. They’re not usually completely well. They’re just better that they don’t need to be there at home, but they still need care, and so it’s really important they follow up with their doctor’s office and the challenge is that the hospital now needs assurance that that follow is going to happen, in that they need to know what happens out of that visit. And so what we do is we close that gap in technology between the hospital and the doctor’s office. But therein lies a new wrinkle which is the doctors on one platform, they got their own electronic medical record system, there are a hundred vendors here at HIMSS selling electronic medical record systems for physician offices, and there are 50 more that sell them for hospitals.”