As more payers and providers implement value-based care (VBC), treatment increasingly is shifting to a patient’s home or community setting. For payers, integrating community-based organizations (CBOs) into traditional care networks offers both an opportunity and challenge.
The opportunity comes in the form of social determinants of health (SDOH) that CBOs can provide to inform wellness care plans. Knowing a patient’s employment status, housing situation, transportation barriers and other nonmedical information helps payers and providers gain a comprehensive view of that patient. This enables them to suggest lifestyle changes and recommend support resources, such as smoking cessation classes.
But integrating SDOH into care coordination is only half the battle. Equally important is payers employing a mechanism for compensating CBOs as care delivery partners. Otherwise, these organizations—many of which are nonprofit or otherwise on tight budgets—lack the ability to participate in a VBC network. It is up to payers, or holders of the financial and outcome risk for the individual, then, to create the digital network infrastructure and processes to add CBOs to their VBC models and pay them for their services.
Read the full article here: https://www.fiercehealthcare.com/payer/industry-voices-onboarding-model-for-cbos-value-based-contracts