Since the Affordable Care Act was introduced, shifting from volume-based to value-based care has been a tedious process with countless implications for surgeons. When high-value provider networks were introduced to reduce premiums and promote more affordable coverage for consumers, surgeons were forced to rethink their care delivery strategies. As experts in helping hospitals save money and supporting surgeons to achieve their individual career goals, NexGen Surgical knows how to navigate high-value provider networks.
The Basics of High-Value Provider Networks
The use of high-value provider networks is a mechanism utilized by health plans to reduce costs and improve outcomes by providing incentives for high-quality and cost-effective care providers. High-value provider networks include providers who consistently meet quality and safety metrics and are more efficient in comparison to their competitors. These providers are willing to offer greater discounts to insurance companies in exchange for being one of fewer preferred providers, making it more likely for them to be chosen by an insured member for medical services. High-value provider networks are part of a larger initiative to embrace value-based payments as a way to reward providers for delivering high-quality care at a lower cost.
Helping Surgeons Enhance Value
High-value provider networks encourage a departure from pure volume metrics by focusing on efficiency and quality. These networks are an increasingly useful tool for health plans to reduce costs and supply incentives for providers. Surgeons must be vigilant in their commitment to provide the most efficient and best quality care possible in order to continue as part of these networks. To remain valuable to an organization, surgeons must be able to offer integrated, high-quality services rather than simply treating a high volume of patients. NexGen Surgical helps surgeons focus more time and attention on quality of care by removing administrative burdens from their responsibilities. Additionally, since NexGen surgeons only work two weeks per month, they can spend more time learning new skills or enjoying relaxation time that can lead to increased quality of patient care.
Supporting Hospitals in Maximizing Revenue
Hospitals are increasingly subsidizing losses to physician groups. Consequently, hospitals try to recover these losses by leveraging higher reimbursements and avoiding penalties through improved coordination of care and quality of care. By keeping our surgeons up to date on standards of value-based care and participating in high-value provider networks, NexGen Surgical supports hospitals in maximizing revenue. Additionally, our sister company, CCI Anesthesia, can help our clients by co-managing perioperative services in ways that enhance value and build volume.
Ensuring Success After Joining High-Value Provider Networks
Joining high-value provider networks poses an opportunity for facilities to distinguish themselves from competitors by demonstrating their ability to deliver reliable, safe, high-quality care at lower costs. Facilities that refuse to recognize the shift to value-based care risk a decrease in both patient volume and reimbursement. Change is hard—we know. However, with NexGen’s involvement, surgeons and hospitals are better prepared to succeed in high-value provider networks. With tightening reimbursements, stricter regulations and growing competition to attract patients, well-trained and experienced surgeons become more valuable than ever.
Why Surgeons Choose NexGen Surgical
NexGen Surgical’s model gives hardworking surgeons the ability to embrace a healthy work–life balance without having to relocate, take calls during time off or waste time away from their practice working on billing, payroll or staffing issues. When our surgeons are at work, they are providing high-quality care for patients—not wading through administrative duties. If you are an experienced surgeon, regardless of specialty, you may be an excellent fit for the flexible lifestyle at NexGen Surgical.
Contact us today and a recruiter will be in touch soon to discuss your background, experience and career goals.
