Top 10 Strategies for Managing “Fusion” Reimbursement Models

Reimbursement Models

Reimbursement Models

The state of the healthcare industry is a volatile one at the moment. This has led to many challenges for businesses in this currently chaotic industry going forward into this decade. While some companies prefer to play it safe, others are facing these challenges head on and embracing new “fusion” reimbursement models. However these news strategies can be risky for those who are unfamiliar with them. Let’s go over the top ten ways to manage fusion reimbursement systems.

1. The Importance of Adopting New Payment Models

With older payment models falling by the wayside due to economic trials and tribulations, the healthcare industry is embracing new methods such as bundled payment options and even joint venture plans. Much of this is focused on high cost, high volume areas such as cardiology and other similar fields of medicine.

 

Execution Matters

Execution Matters

2. Why Execution Matters

It is no secret that many good ideas crash and burn because they are ultimately poorly executed. To see the new fusion strategies through, healthcare providers will have to possess strong conflict resolution skills as well as exceptional communication skills. This, combined with the ability to influence others, will be needed to ensure that these new financial models are successfully implemented.

3. Following in Google’s Footsteps

Google is known for both its creativity and its forward thinking which has led to its success. To make new fusion reimbursement models work administrators will have to take a similarly assertive mindset when looking for new talent as well as in identifying the most valuable human resources they currently possess and how to use them. High value, high quality, and high responsiveness are the cornerstones of the future.

 

Risk vs. Reward

Risk vs. Reward

4. Risk vs. Reward

Those who take the greatest risks will reap the greatest rewards. This universal truth applies to fusion reimbursement models as well but the risk must a managed one. The key is to stay open minded and look at the future from a broader perspective, ensuring that no opportunities are missed and that they are acted upon quickly, intelligently, and with the proper planning. A tolerance is also important, which we’ll go over in just a bit.

5. The Value of Timing

During the midst of a turbulent time of payment transformation, such as the one happening now, it is important to understand the value of timing. ACOs and bundled payments are working against demand and forcing providers to rethink their business models. Being able to time new fusion reimbursement models with changes in care models will be critical to future success.

 

Best Practices

Best Practices

6. The Evolution of Best Practices

One of the toughest tasks associated with the rise of fusion reimbursement models is the fact that there are no real set best practices yet. However, this doesn’t mean that businesses can slack off. They will have to be able to learn not only from their own successes and failures, but from the successes and failures of their competition as well if they want to establish best practices that work.

7. The Value of Proximity

When it comes to navigating the chaotic changes that the healthcare industry is currently facing, being able to communicate face to face with colleagues, employees, partners, and more is critical to success. Being able to break down barriers and foster a sense of trust and reliability has never been more important.

 

Courage is Key

Courage is Key

8. Courage is Key

Getting through this age of healthcare strife will also require a great deal of courage. That is, the courage to turn down payment models that are inefficient no matter how easy they seem. The courage to stick with long term plans and ignore short term fixes that lead to bigger problems. Finally, you need the courage to confront the reality of waste, duplication, and other consequences of fee-for-service business models.

9. Failure Tolerance

The ability to tolerate failure and learn from it is and has always been an important component of a great leadership program. Failures should be reclassified as “education” and serve as a guide point on the path to success with fusion reimbursement models. True innovation is impossible without risk and risk rarely comes without some degree of failure. Managing risks and keeping them within the bounds of tolerable failure is going to be important for as long as business exists as we know it.

 

The Value of Partnership

The Value of Partnership

10. The Value of Partnership

Now more than ever healthcare providers will be forced to partner with one another in order to establish payment and care models that work. In fact, partnership across many different healthcare stakeholders will work as a fact based comprehensive market assessment. This will allow providers to learn from one another what’s working and what isn’t so that all can profit from that knowledge. In some cases partnerships that take advantage of one another’s services will also be beneficial and allow all parties to ultimately achieve a greater level of patient-centered care.

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