FAQS
Frequently Asked Questions
Have questions about value-based care or what it means for your practice?
This FAQ page addresses the most common concerns that independent practitioners face, from understanding new requirements to learning how Practice Impact Partners can help you transition and thrive in the value-based care landscape.
Value-Based Care FAQs
Value-Based Care (VBC) is a healthcare payment model that rewards providers for the quality of care they deliver, rather than the quantity of services they provide.
The focus shifts from fee-for-service (FFS, volume) to improving patient health outcomes and managing population health efficiently. This approach prioritizes prevention, team-based care, and overall patient wellness.
These are summarized as the “Quintuple Aim,” the new healthcare standard (IOM):
- Individual’s health improvement
- Overall improvements in population health
- Healthcare equity
- Better quality of life for providers
- Lower costs of care.
The U.S. Department of Health and Human Services (HHS), and the Center for Medicare and Medicaid (CMS), has mandated that by 2030, all Medicare and Medicaid members must be in a value-based care arrangement.
This means the traditional fee-for-service model is being phased out for these patient populations. For independent practices, making this transition is essential for future financial stability and the ability to continue serving Medicare and Medicaid patients.
Practices that do not transition to a VBC-compliant model risk becoming ineligible to receive payments from Medicare, Medicare Advantage, and Medicaid. This could significantly reduce your patient base and revenue, ultimately threatening the long-term survival and independence of your practice.
The transition from FFS to a VBC ready practice/business, on average takes about 2 years, and $2.5 M. This, of course, is dependent on the capability of the practice at the start. This includes the emotional buy-in, which is critical and essential without which the time and money invested could be greater.
Independent practices may struggle with making the transition to VBC on their own due to various factors. One of the main reasons is the lack of leadership demonstrating total buy-in. In the above question “...transition…” the response states “...practice/business…” This is important because practitioners must realize the greatest transition is that they’re operating a healthcare business, a significant cultural shift. It doesn’t change who you are professionally, but healthcare payers have moved on from “the doctor’s office.”
The shift from a fee-for-service model (an RVU model based care of one person at a time) to a value-based care model, which is outcomes based on populations, thus requires and is dependent on payment contracts. This can be overwhelming for independent practices that do not have dedicated staff or experience in these areas.
Independent practices face challenges in negotiating contracts with payers and understanding reimbursement structures under VBC. They may also struggle with managing the financial risks involved in VBC, as it requires them to take on more responsibility for patient. THIS MEANS RISK ASSUMPTION!
It means that when you enter into a payer contract you’re agreeing to assume the fiduciary risk for patient outcomes. In other words, the contract is going to present you with contractual conditions for you to get paid based on expectations by year's end for all patients that are attributed to you. Therefore, you agree to manage the patient’s risks of their care e.g. preventive care, reductions in admissions to hospital and ED, etc.
This can be overwhelming for smaller independent practices that may have limited staff and resources. Lack of experience in data analysis and reporting can also be a barrier.
No practice is too small to transition to value-based care (VBC). Smaller practices often have unique advantages, such as closer patient relationships and a more personalized approach to care, which can align well with the goals of VBC.
While the transition might feel daunting, proper planning, strategic partnerships, and focusing on high-impact areas can help any-sized practice successfully make the shift.
By leveraging tailored resources and support, even small practices can, and are expected to, transition, hopefully, with the help of Physicians Impact Partners (PIP).
Working with Practice Impact Partners FAQs
Practice Impact Partners provides a comprehensive suite of physician-led capabilities to guide your practice through every step of the transition. We offer the expertise, resources, and hands-on support you need, both in-person and virtual, including technical integration, legal guidance, financial planning, and leadership training for all professionals and staff. We handle the complexities so you can focus on patient care.
Absolutely. Our entire model is designed to empower independent primary care practices. We provide the tools and support necessary to thrive within the VBC landscape, allowing you to maintain your autonomy and avoid selling to a hospital system or private equity firms.
Both in-house and virtual training programs are designed for your entire team for success in a VBC model. Our training focuses on developing a team-based approach to care, implementing prevention strategies, and mastering population health management. We ensure your staff is confident and prepared for the new operational workflows
This is dependent on the capabilities of the practice at the outset. Once determined we meet with the key members of the practice and map out a plan of action that agrees with the team.
One area that can greatly benefit from VBC transformation in primary care is cardiac rhythm monitoring. This is a vital tool for detecting and managing various heart conditions, ranging from arrhythmias to heart failure. With the rise of chronic diseases and an aging population, the demand for effective cardiac care is only expected to increase.
Innovative technology has revolutionized cardiac rhythm monitoring, making it more accessible and efficient than ever before. Primary care practices can now offer advanced devices such as implantable loop recorders, wearable monitors, and smartphone-based solutions to their patients. These tools not only improve patient convenience but also provide real-time data that enables more accurate diagnoses and treatment plans.
We will ensure that these additional services are billable.
By partnering with us, you can successfully navigate the transition to VBC and unlock significant benefits. These include securing your practice's financial future, improving patient health outcomes, increasing operational efficiency, and maintaining your independence. You'll be positioned to not only survive but thrive in the new era of healthcare.
The timeline and resources can vary, but Practice Impact Partners streamlines the process to make it as efficient as possible. We create a customized "Treatment Plan" for your practice that outlines the specific steps, timeline, and support structure. Our goal is to manage the heavy lifting, minimizing disruption to your daily operations.
After transitioning with Practice Impact Partners, practices can expect to see significant financial benefits. With the implementation of advanced technology and streamlined processes, practices will experience increased efficiency and cost savings. This includes reduced administrative burden, optimized revenue cycle management (RCM), and improved patient satisfaction.
Additionally, the use of advanced cardiac rhythm devices can lead to faster and more accurate diagnoses, resulting in reduced healthcare costs for patients. This can also lead to improved patient outcomes and a higher retention rate for the practice.
However, PIP doesn’t just seek to improve what you’re losing from poor revenue cycle management but also from other revenue streams that the business never considered or implemented, e.g. chronic care management and other remote patient monitoring opportunities. Meaning, the recovery of lost RCM, adding new sources of revenue, including from VBC contracts with bonus payments, and higher per member per month (PMPM) payments due to improved patient risk profiles (HCC and RAF scoring).
Partnering with Practice Impact Partners also allows practices to stay up-to-date with advancements in technology and healthcare regulations. This ensures that the practice remains competitive in the ever-evolving healthcare industry.
Transitioning with Practice Impact Partners also provides opportunities for professional development and growth for physicians and staff. These partnerships often offer training programs and support for implementing new processes and systems achieving continuous quality improvement (CQI) within the practice.
Getting Started FAQs
Getting started is simple. The first step is to schedule a consultation with our team. We’ll discuss your practice's unique situation, answer your initial questions, and explain how our framework can be tailored to meet your specific needs and goals. We then develop a physician participation agreement (PPA) specific to you, or group.
We are a physician-led organization with firsthand experience in running successful independent practices. We don't just advise—we partner with you to implement proven systems and provide the hands-on support needed for a successful transition. Our model is designed to develop a large, national Independent Practice Association (IPA), which gives every participating practice leverage as a group, in contract negotiations. Additionally, you also have the opportunity to become a partner in the PIP family, enjoying even more long term financial benefits of the relationship. PIP is built by doctors, for doctors, ensuring your practice's clinical and financial goals are always understood, and aligned.
The cost of working with Practice Impact Partners is minimal compared to the financial, operational, and clinical losses that occur when a practice/business does not transition to value-based care. And that’s the best you’ll get, - not transitioning. The worst is, - your business will close, with no recovery.
By 2030, CMS requires 100% of Medicare and Medicaid beneficiaries to be aligned with value-based care or ACO models.
Practices that fail to transition will no longer be eligible to receive Medicare, Medicare Advantage, or Medicaid payments. For most independent primary-care practices, this represents 40–80% of total revenue.
The cost of not transitioning can result in:
- Loss of major payer contracts (Medicare, Medicaid, MA plans)
- Immediate and irreversible revenue decline
- Inability to compete with VBC-aligned networks
- Rapid patient attrition to other VBC businesses
- Increased administrative burden with decreasing reimbursement
- Loss of practice value, making it extremely difficult to sell
- Higher risk of burnout, turnover, and staff instability
- Eventual closure or forced acquisition by private equity or large health systems
In contrast, working with Practice Impact Partners allows your practice to preserve revenue, increase profitability, and position itself for growth under CMS’ mandated payment model.
When you partner with PRACTICE IMPACT PARTNERS, you gain:
- A turnkey, physician-led transition plan
- Practice-management systems that improve productivity
- Value-based care pathways tailored to your patient population
- Prevention, population health, and team-based care training
- Access to expert leadership, financial, legal, and technical support
- Increased practice value if selling becomes part of your strategy
- Identifying other revenue streams, e.g. cardiac monitoring, chronic care management (CCM), remote patient monitoring (RPM) solutions, etc., that strengthen both outcomes and revenue
- A structured Growth Prescription that yields sustainable results
- Become a partner in PRACTICE IMPACT PARTNERS.
In short:
The real cost is not transitioning. Failing to adapt puts your entire practice at financial and operational risk.
Working with PRACTICE IMPACT PARTNERS protects your revenue, increases profitability, strengthens independence, and prepares your practice for long-term success in the value-based era.
