Value-Based Care Flashcards
1
Q
Value-Based Care
Purpose
A
- Improve patient experience
- Reduce per-capita medical spend
- Improve population’s health
2
Q
Value-Based Care
Value-Based Care Framework Capabilities
A
- Strategy
- High-Performance Network Management
- Population Health Management and Quality
- Enterprise Risk and Financial Management
- Data Management
- Consumer Engagement
- Analytics and Reporting
- Enabling Technology
- Business Operations Excellence
- Product Leadership
- Organizational Change and Talent Acquisition
3
Q
Value-Based Care
Value-Based Care Framework Capabilities
A
- Strategy
- High-Performance Network Management
- Population Health Management and Quality
- Enterprise Risk and Financial Management
- Data Management
- Consumer Engagement
- Analytics and Reporting
- Enabling Technology
- Business Operations Excellence
- Product Leadership
- Organizational Change and Talent Acquisition
4
Q
Value-Based Care
Strategic Considerations
A
- Overall strategy objectives
- Provider strategic motivation
- Balance risk appetite
- Financial Implications for Providers
- Possible Outcomes by Modeling:
- Traditional Financial Levers
- Clinical Interventions
- Underlying cost structure of providers
5
Q
Value-Based Care
8 Medication-Use Quality Measures on Which to Evaluate Pharmacies
A
- Medication Adherence
- Hypertension
- Cholesterol
- Diabetes
- Dx Management
- Statin use in persons with diabetes
- Suboptimal control of asthma
- Absence of controller inhaler in asthma patients
- Pharmacist health coaching
- Patient Safety
- High risk Medication in Elderly
6
Q
Value-Based Care
Reasons Initial Metrics were Selected for Pharmacy Initiative
A
- Address areas of high priority
- Can be directly impacted by pharmacists
- Easy to track and understand
7
Q
Value-Based Care
Initiative Phases
A
- Performance Reflection (Reflect on scorecards)
- Performance Disclosure (Final scores)
- Performance Accountability (Tie pharmacy reimbursement to overall performance)
8
Q
Value-Based Care
Initial Objectives of Pharmacy Initiative
A
- Assist pharmacies to identify most high-need patients for intervention
- Support evolution of pharmacy profession to delivery high-quality patient-centered care
- Performance feedback to facilitate improvement
