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Why Healthcare is Broken, and How We Fix It

healthcareisbroken

To say that U.S. healthcare is troubled is an understatement. Ours is an extraordinarily expensive system; the U.S. spends $3.2 trillion per year – more than Canada’s entire Gross National Expenditure – for care that is statistically comparable to Cuba’s. In fact, the Cuban infant mortality rate is lower than ours. And, unlike in Cuba, U.S. patients complain about the rising cost of high deductible plans and medical services. U.S health care also fails on basic safety measures. In short, for all of the money we pour into it, our healthcare system produces underwhelming results on a variety of metrics.

These high costs and disappointing outcomes have spurred healthcare stakeholders to begin to repair the system. Government, payers, and providers are now uniting in their efforts to shift from fee-for-service to quality, value-based-payments, where doctors are paid based on whether the care they provide improves their patients’ health. This $1.6 trillion shift to value-based care requires providers to focus on three areas to align their performance with value-based care goals: providers must now improve patient experience, improve the health of populations, and reduce the cost of healthcare.

At Privia, we’re here to help independent physicians make this transition and improve on these targets. We’re an outcome-obsessed company that aligns with independent doctors to drive value into the system by forming a well-oiled, coordinated care machine around our physicians to help them achieve success under a rapidly evolving healthcare system.

Under value-based-care, providers are held financially responsible for quality-of-care. You must be able to track and report your metrics in order to be reimbursed. Requirements for success under this new system include:

  • Thorough data and analytics on patient outcomes and wellness.
  • Creating care management programs including plans for medically complex patients, chronic care, and medication management.
  • Monitoring transition of care (facility steerage, hospitalist programs, and acute event plan)
  • Continued prevention and engagement through quality measure sets, and specialist referrals to high-quality low-cost counterparts.

Our doctors are equipped with the sophisticated technology, robust infrastructure, and professional staff to succeed in all of these categories. We free doctors from the administrative and IT burdens that consume their energy by coordinating payer contracts and strategic partnerships, providing population health support, providing billing and collections support, and allocating a dedicated performance consultant to each practice. These resources and patient-centric care teams allow Privia providers to practice better medicine, take care of complex patients, and get reimbursed for high-quality care.

Privia was founded on the belief that the physician-patient relationship should be at the center of our system, and physicians should be rewarded for the value they create. It is our mission to change healthcare for the better, enable our physicians to rediscover the joy in medicine and provide their patients with the quality, convenient and accessible care they deserve.

To speak with a director of physician development who can evaluate your practice’s preparedness for the new world of value-based-care, please email physicians@priviahealth.com.

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