Melissa Stratman

07 Dec, 2017
Follow Coleman!

Melissa Stratman

07 Dec, 2017
Follow Coleman!

How to Prepare for Success in Value Based Payments

In the last article we introduced the concept of Value Based Payment and the evolution of the outcomes rewarding system.  In this article we explore how you can begin to evolve your organizations infrastructure to be best prepared for a Value Based Payment (VBP) reimbursement system. This article also highlights for those who are embarking on a Coleman Initiative how DPI™ will help better prepare you for a world that accounts for Value-Based Payments.

How should we prepare for VBP?

There are a few ways to prepare for value based payment changes. In this, the second in the VBP series, we will examine some of the overarching structures and changes that should be put into place in order to lay the groundwork for the last steps to be taken, which will be described in detail in the third article of the series.

The initial steps include ensuring that quality data and metrics for patients are accurately entered in the electronic health record (EHR). Templates and ticklers as well as systems to document more easily will help in this process.

Accountable Care Organizations (ACOs) as the name implies are organizations built to be accountable for the quality, cost and care experience of an assigned group of patients. Some ACOs and Managed Care Organizations (MCOs) are beginning to provide Value Based Payment benefits to sites that provide quality and one metric of quality is Patient Centered Medical Home(PCMH) recognition. While no recognition/accreditation system is without its flaws, a PCMH strives to ensure that patients get access to quality, coordinated care during every step of their health care experience. Both the National Committee for Quality Assurance (NCQA) and the  Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) offer an accreditation that requires demonstration of simple adherence to policies and processes.

Of course, having Patient Centered Medical Home recognition does not ensure that patients are receiving high quality of care, or that patients experience a simplified way to access care in ways that are linguistically and culturally appropriate, including emerging transgender care sensitivities. For many practices, this is where the Coleman Dramatic Performance Improvement™ process becomes so critical to their success.

Coleman Associates understands the Medical Home accreditation requirements, but more importantly, Coleman staff have experience working in the trenches to bring these requirements to life with every front office clerk, medical assistant, nurse, social worker, pharmacist, nurse practitioner, doctor, and administrator. Having been on the receiving side of Coleman training and support, we have walked a mile in their shoes.

Practices know that as part of the accreditation or re-accreditation process they must complete certain steps and be able to demonstrate that they have policies, processes and data to substantiate their compliance claims. One of the biggest challenges facing practices is getting staff and providers to understand, embrace, and live the required changes. The Coleman DPI™ has helped practices by teaching them both the techniques (e.g. checklist and documentation for visit preparation) and soft skills (e.g. brief and effective communication with the doctor) needed to help care team members move successfully through the systemic level of change.

Traditional process improvement programs, whether they are touted as rapid cycle improvements or more traditional improvement approaches, often do not provide enough disruptive innovation thinking and are not taught with enough depth and breadth of experience to truly unseat old habits and replace them with new ones. The re-development of habits turns out to be a critical disruptive step in the change journey, and when not given adequate attention it can create a fatal flaw in most process improvement progress. Unfortunately, skimming over this step or not insisting that best practices become the new way of working can leave well-meaning progressive staff feeling like their improvement energy has been for naught; besieged by the demands of the job, some staff move forward and some staff continue to hold on to old ways, leaving the practice in a frustrating place of remaining stuck in the status quo despite making significant efforts to enact positive change.

The DPI™ training helps to tailor best practices, create and establish sustainable techniques for improved processes, and redefine the roles of staff in ways that give practices the best chance to provide patient centric comprehensive care.

DPI™ supports the patient care team members by teaching them the specific techniques that allow them to provide comprehensive care to patients as a care team. This is in contrast to practices that either increasingly heap ownership for changes on the already full plate of the physicians or those who educate staff on changes by discipline (rather than by team), which often leads to confusion and frustration regarding responsibilities in the gaps between job roles.

DPI™ builds managers by helping to teach them new techniques for management. DPI™ models use real time data to drive change and to show how to teach, coach and hold people accountable to new systems. DPI™ also demonstrates how to collectively raise alerts around infrastructure changes that are needed to support the new processes.

These are all ways that the DPI™ or Coleman Dramatic Performance Improvement program is much more than just an improvement methodology. DPI™ is an all-encompassing program that looks at the components of the visit, the phones, referrals and follow up, behind the scenes tasks, data review, and provider charting.  Reducing DPI™ to an improvement program erases all of the finesse and magic that makes DPI™ such an effective experience. The Coleman Dramatic Performance Improvement™ program is chock full of opportunities to challenge the status quo, which helps change the underlying culture. If offers practical hands on techniques, all taught by trainers who have themselves implemented these techniques and have found them to truly improve processes for practices.

DPI™ training:

  • Provides change management support and training
  • Tailors best practices to meet the needs of patients and staff
  • Adjusts the model of care to meet the current staffing patterns as well as the architecture of the practice
  • Builds and establishes techniques for getting to and sticking with improved processes
  • Creates stronger care teams to inform any redefinitions of roles of staff

With Value Based Payment changes on the horizon, practices must transform in order to be successful in this changing payment system.

The next article in this series you can read about Seven Steps to Take Now to Prepare for Value Based Payments.



Coleman Associates. Rapid DPI™

Coleman Associates. An Introduction to Transgender Health Care.

Joint Commission on the Accreditation of Health Care Organizations.

National Committee for Quality Assurance.



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