Navigating the Shift to Value-Based Care: Investing in the Patient Experience

Many have analyzed the current state of healthcare and the key issues that plague our industry. From skyrocketing costs to subpar quality outcomes and unequal access to care, it is clear that the challenges are immense. In the past, healthcare payments from insurers came after providing services to patients, known as a fee-for-service model. However, this model did little to address health outcomes, access to care for vulnerable populations, and the increasing national healthcare expenditure. It is evident that our traditional healthcare delivery system needed improvement. As a result, the healthcare industry is witnessing a pivotal shift from the traditional fee-for-service model toward a value-based care model, whose focus on patient outcomes aligns with an increased focus on patient experience.

The solution: Value-based care

Unlike the traditional model of collecting fees for services, where healthcare providers earn based on the volume of services rendered, a value-based care model emphasizes the quality of care delivered and its impact on patient outcomes, cost, access to certain services, and the patient experience. Consequently, healthcare organizations have incentive to prioritize improving care coordination, providing cost-effective care, and ensuring a superior patient experience.

Patient experience

With the shift in payment models and other market forces such as changes in consumer behavior and increased competition, healthcare providers can no longer expect patients to be passive stakeholders in their care. Patients now have more choices regarding where and how they want their care and are more proactive and empowered than ever before. As a result, healthcare providers who focus on the patient experience will gain a competitive advantage over those who don’t.

The Beryl Institute, a global community of healthcare professionals and experience champions, defines patient experience as “the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care.” This definition encompasses every digital and physical touchpoint a patient has within the healthcare system, from scheduling appointments to receiving treatment and follow-up care. Investing in patient experience initiatives involves listening to patients and streamlining operational and clinical processes to ensure a seamless and positive experience for patients at every touchpoint within the care journey.

Return on investment

Research on patient experience shows that positive service experiences can lead to higher levels of patient satisfaction, increased patient engagement, and improved health outcomes. In the article titled, “Return on Service: The Financial Impact of Patient Experience,” by Jason Wolf, Executive Director of The Beryl Institute, Wolf writes that “from the marketing perspective, if you invest in building customer loyalty, it contributes to the bottom line through referrals or repeat business. From the clinical perspective, if you can decrease length of stay or reduce readmissions by providing a positive and quality experience, it impacts the bottom line as a result of greater throughput, reduced expenses or unaffected reimbursements.”

Additionally, Wolf uncovered that more satisfied patients are less likely to sue and that hospital profitability tends to increase with overall patient satisfaction. Moreover, satisfied patients are more likely to adhere to treatment plans, follow preventive care guidelines, and recommend the healthcare organization to others. By prioritizing patient experience efforts, healthcare organizations can differentiate themselves in a competitive market and build patient loyalty.

The strategy

Here is a four-part strategy that helps address the shortfalls:

Data and analytics

As the saying goes, “If you can measure it you can improve it.” Healthcare organizations must leverage data to gain insights into the patient journey, identify areas for improvement, and make informed decisions about how to improve care outcomes and the overall experience. Additionally, advanced data collection is necessary to report outcomes and metrics for health networks and payers providing incentive payments to value-based care participants.

Technology and innovation

Advancements in technology create opportunities for healthcare organizations to become more creative, efficient, and effective at delivering care and meeting patient expectations. Forbes, in an article titled, “How Technology Is Improving The Patient Experience And Health Outcomes,” documents the positive impact technology has on the patient experience and health outcomes. They note that “digital upgrades like electronic prescribing, medical alerts, and clinical flags can further reduce medication errors and measurably improve patient safety.” In sum, organizations that want to differentiate themselves from the competition must harness health technology solutions such as electronic health records (EHRs), telehealth platforms, patient portals, and other software to enhance care delivery, patient engagement, and access to services.

People

Over the past couple of decades, there has been a significant increase in patient experience roles within healthcare. For patient experience initiatives to thrive, it must be a top priority for the entire organization, starting with senior leadership and clinicians. Once senior leaders and clinicians buy in, patient experience efforts have a better chance of being more effective as organizational priorities. Moreover, educating your staff on the importance of embracing patient experience and implementing best practices ensures that healthcare teams are equipped with the knowledge, skills, and tools necessary to succeed.

Continuous improvement

To ensure a superior patient experience, it’s important to regularly measure and evaluate the processes, initiatives, and programs that aim to improve the overall experience for patients and employees. Engaging with key stakeholders to utilize data and address concerns in a structured, lean, and organized way is imperative. Processes sometimes break down, patient expectations are constantly changing, and new health technologies are always on the horizon.

What’s next?

As healthcare continues the shift towards value-based care, the importance of prioritizing the patient experience must be a priority for healthcare entities that want to survive and thrive. Those that do so will benefit from seeing improved patient outcomes, greater clinical and operational efficiency, and financial stability. Ultimately, the journey toward value-based care is not just about changing payment models — it’s about transforming the way we deliver and experience healthcare to meet the needs of those we serve.