A VBP network project team involves multiple disciplines. One discipline that must be represented at every level is the financial team. A VBP network could be the most effective in the world in meeting quality indicators and out of business quickly if the costs of meeting those indicators create a loss. Until now, the health care industry has been focused on the creation of a set of measures to determine whether physicians and providers are delivering quality care. There should be more emphasis paid to the financial and legal issues that populate the development of a successful program. The development of meaningful quality indicators is so critical to the development of a successful VBP program that it is not unusual that the financial and legal issues related to the process have not been the center of attention. Physicians and hospitals can no longer allow the discussion about VBP to be centered on only the quality indicators themselves.
Hospitals and their medical staffs are increasingly pressed to organize in ways that facilitate their collaborative participation in VBP programs. Combining the hospital and its medical staff into a collaborative treatment model using evidence-based medicine has shown promise in reducing mortality and morbidity rates in participating hospitals over episodes of care.
Collaborative evidence based medicine is a team sport. While compliance with some outpatients quality indicators are driven by the actions of an individual physician, the ultimate focus of VBP programs will center on episodes of care. An inpatient episode of care my include primary care, specialist and hospital based physicians, hospital facilities and personnel, and in some instances a long term care facility. Organizing a delivery system in a manner that coordinates the services is key.
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