Value-Based Care in Urology: Why You Need It

Value-based care is becoming increasingly important in healthcare. Even outside CMS requirements, value-based care in urology has the potential to transform practices that are looking to prepare for the future. While some unique challenges exist for urologists looking to participate in value-based care, these reimbursement programs can help improve clinical outcomes and establish financial stability. 

Implementing value-based care in urology practices helps to enhance patient outcomes while optimizing operational efficiency. 

What is Value-Based Care?

Value-based care is a specific type of payment model that determines payment based on the quality and value of care delivered, rather than the traditional model of the number of services completed. Value-based care aims to reduce healthcare costs and improve quality by rewarding providers for patient outcomes. .

Approximately 70% of urologists participated in MIPS, one type of value-based care program, in 2022.

Understanding Value-Based Care in Urology

Benefits

Urology practices that participate in value-based care are able to:

• Improve patient outcomes with increased adherence to medical guidelines, better management of chronic conditions, and reduced risk of complications
• Streamline practice efficiency by increasing focus on preventative care and improving care coordination.
• Reduce administrative burdens as reimbursement processes are streamlined and payment is received faster.
• Increased satisfaction from doctors who can focus on providing high-quality care rather than a high volume of care, and patients who experience high-quality care. 
  
  

While value-based care in urology is beneficial, the limited number of quality measures and bundled payment offerings relevant for urology make participation particularly challenging.

Challenges

While value-based care in urology can drive numerous benefits for the practices and doctors that participate, like other specialties, there are a few challenges:

• Defining value is particularly difficult as there is no clear-cut answer, and very few quality measures apply to urological conditions.
• Condition-specific models are most applicable to urologists; however, as CMS continues to reduce the number of available payment programs, the future of these models is unclear.
• Data collection and analysis are critical components for all value-based care programs. However, implementing the systems required to gather these key quality metrics is a significant and complicated investment. 

Value-based care in urology will likely be a requirement in the coming years. 

CMS is aiming for all participating physicians to transition to value-based programs with their patients by 2030. 

How to Implement Value-Based Care in Urology

While transitioning to value-based care is no easy feat, it’s not going away any time soon. Even if CMS makes a radical move to another type of payment program, one thing is sure: it’s all based on metrics. 

That’s why we recommend investing in solutions that help you capture and track the metrics that matter in your practice. This makes it easier to participate in value-based care and provides you with the tools you need to track your practice's performance now and for any future reporting requirements. 

Our Recommendation: Work with an Expert Urology Partner

Figuring out what you need and how to implement it in your practice can feel overwhelming, but you don’t have to do it alone. By working with an expert urology partner, like TRIARQ, we can help you build the infrastructure needed to participate in value-based care and determine other areas for optimization in your practice. We handle it all for you so you can focus on providing high-quality care to your patients. 

Our approach combines advanced technology with urology-specific expertise to create a custom strategy for your practice. We build an infrastructure so you can understand and report on the metrics to meet your value-based care requirements. This makes it easy to: 

• Improve patient outcomes and care coordination
• Design care pathways
• Understand the patient experience
• Monitor quality of care
• Reduce costs
• Identify where to eliminate waste and inefficiencies 

By working with TRIARQ, you will establish the infrastructure to report on key quality measures and any other future metrics required of various payment and reimbursement programs. 

Ready to Get Started with Value-Based Care in Urology?

Transitioning to value-based care can seem overwhelming. From reporting tools to streamlined administrative processes, it feels like there are a lot of moving parts. However, by partnering with a urology practice expert, like TRIARQ, you have someone who can do it all for you. 

We start with a comprehensive assessment of your practice, including a competitive analysis. Then we create a roadmap for optimizing operations and identifying and implementing growth opportunities, such as value-based care.