Could Value-Based Contracting Be on the Horizon for the WorkComp Arena? Written by Mark Kraemer on 10/16/2017 3:14 AM in business tips, employee management, employment management tips, workplace injury management tips. It has 0 Comments. Value-based contracting models are already being used by the healthcare system. But in today’s workers comp arena, they are a hot-button topic. A Coventry white paper released earlier this year investigated the potential of this model over the current regime. The Argument for Value-Based Contracting (VBC) As opposed to the current workcomp model, in which utilization and care management teams rely on a fee-per-service approach via a discounted network of external vendors, value-based contracting takes a far different approach. Volume-based contracting and fee-for-service care is cast-aside for a payment structure based on performance/outcomes, not services rendered, eliminating the financial incentive to treat more. Quality Value-Based Contracting Models… Unite the goals or payors and providers. Pay for better outcomes (superior quality, faster results) regardless of the number of services rendered to achieve them. Utilize predictive pricing for payors/providers, with agreed upon treatment costs by injury/illness. (All costs for an episode of care, such as knee replacement, are bundled as one fee. Patient-centered medical homes cover patient care coordination and outcomes under a per member, per month fee.) Have an ‘outcome focus,’ relying on a model calibrated to deliver the right combination of services to achieve the best outcome. In this ‘pay for performance’ model, preventative care is seen as a way to curb costs and treat injuries and illnesses before they become serious. (Think: creeping catastrophic claims.) Data analytics monitor a provider or hospital’s success. Could the old claims mentality be replaced by value-based contracting? As the industry strives for savings and improved patient outcomes, time will tell. As the regime evolves, Minnesota Comp Advisor will be here for you through it all.