Private Practice Partnerships: Finding Pathways to Success-Webinar Recording

Video Transcription

Video Summary

Donovan Miske, founder of Kona Medical Consulting, explains the urgent shift from fee-for-service to value-based reimbursement (VBR) in healthcare, emphasizing that participation is mandatory and ongoing. VBR focuses on improving patient outcomes, managing costs, and enhancing care experiences through measurable quality metrics, care coordination, chronic disease management, and patient-centered approaches. Providers are incentivized to reduce unnecessary hospitalizations and readmissions, documented precisely via EMR and data aggregators like Health Focus.<br /><br />Accountable Care Organizations (ACOs) and Medicare Shared Savings Programs (MSSPs) are central models, where groups share savings or losses based on meeting cost and quality benchmarks for defined patient populations. Osteopathic medicine aligns well with VBR's holistic, preventative focus, though quantifying benefits like osteopathic manipulative treatment can be challenging.<br /><br />Success in VBR requires practice transformation (team-based care), advanced data management, patient engagement, and contract negotiation. Advanced payment models increase risk-sharing and integrate social determinants of health. Technology and AI are critical for managing complex data and auditing patterns. Fee-for-service still exists but is increasingly supplemented or replaced by VBR incentives.<br /><br />Miske urges clinicians to proactively adapt to these changes, leverage available resources, and embrace VBR as an opportunity to improve care quality, reduce burnout, and secure financial sustainability in the evolving healthcare landscape.

Keywords

Value-Based Reimbursement

Fee-for-Service

Patient Outcomes

Accountable Care Organizations

Medicare Shared Savings Programs

Osteopathic Medicine

Practice Transformation

Healthcare Data Management