Episode-based payment initiatives, including Bundled Payments for Care Improvement (BPCI) Advanced, the Oncology Care Model (OCM), and the Comprehensive Care for Joint Replacement (CJR) Model, represent an exciting opportunity for clinical teams to exercise full control over patient care, unencumbered by limitations or artificial constraints imposed by payers. At the same time, bundled payments put more risk for the cost of care on the provider. Success under these types of Alternative Payment Models (APMs) requires the ability to impact patient behavior, manage quality, and drive down unnecessary utilization. Providers without the right team in place are in a precarious position. Furthermore, trying to address these issues with costly clinical resources has proven to be an unsustainable and incomplete solution.
Guideway Care’s care guidance program supports and extends your care team, giving you the leverage needed to create patient behavioral change, uncover and address the hidden barriers to care within social determinants, and bridge the gaps patients experience in their care journey. The burden of non-clinical activities is lifted from your clinical staff, with everyone working at the top of their licensure, and patients are empowered to take control of their health. In addition, our program has proven results in decreasing unnecessary utilization, improving the financial performance for participants in bundles. Ultimately, your patients have a better experience of care, your care teams are free to focus on clinical tasks, and you are positioned for success under current and future bundles.