Value-Based Care Report: Practice Insights
Insights from a large practice
The Vancouver Clinic is a large practice located in Vancouver, Washington.
What have been or continue to be some key areas of focus and investment?
Over the last several years, Vancouver Clinic (VC) has taken incremental steps to implement value-based care services. This began in 2016 with the implementation of our Transitional Care Clinic, which helps engage high utilizers with wraparound services and graduate them into more traditional primary care. Panel coordinators began their role in 2017 as VC began to participate in value-based contracts with shared savings. Physicians work to engage patients to get them in for annual visits, as well as their preventive screenings– both of which support our chronic care redocumentation and care gap closures.
Finally, in 2022, Pharmacy Services expanded to cover a variety of services, including Part D spend management and quality measures, most particularly medication adherence. Moving into the future, as we continue our journey to full risk, our goal will be to implement care and disease management and population health services in 2023 and work to identify a third-party administrator to support us in claims payment and authorization review in 2024.
How has the relationship with payers evolved under value-based care?
Regular communication with our payer partners involved in our value-based care contracts has become increasingly important. In addition to our standard joint operating committee meetings, regular workgroups have become key. They allow us to identify problems with the integrity of data within payer portals, delays in transmissions of important data, such as eligibility that feeds our registries, and issues with file exchanges such as with quality submissions. It also allows us to learn of best practices that may be shared by other organizations.
What is a lesson your practice learned that led to success?
Setting up the appropriate infrastructure is key to being successful. One area identified as an area of opportunity was our best practice advisory (BPA) for chronic conditions. Our current BPA had to be navigated to a specific area of the chart and opened before you could see any of the conditions.
After some recent updates, the BPA is now a hard stop and requires providers to either delay addressing, remove or address the conditions. Just hovering over it also provides additional information on the chronic conditions of the member.
What are some outcomes your practice and patients have experienced?
Most recently, Vancouver Clinic has begun assessing its net promoter score. While most healthcare organizations and insurance companies are about on par with airlines, around 50%, adult medicine at Vancouver Clinic is consistently around 80% and has even hit a high of 90%.