Data exchange: Focus on improving the ease and volume of data exchange between emergency physicians and other stakeholders, such as health plans and hospitals. Risk stratification tools often require integrating data on demographics, encounter history, clinical metrics, and social determinants of health. Standardized and transparent data sharing can enhance tool utility and payer–clinician alignment.

Proactive collaboration with payers: Proactive outreach to leaders of commercial or managed care insurance plans can be a productive way to create opportunities centered on value-based care. Meeting with key players, such as physicians or quality executives, can initiate discussions on shared pain points, a shared vision for patient care, and potential sources of funding for alternative payment models. This approach fosters alignment on objectives and paves the way for sustainable partnerships that benefit patients and providers alike.

Strategies to Increase Access to Alternative Payment Models (APMs)

To further accelerate the adoption of value-based care in emergency medicine, several strategies are recommended:

Essential building blocks: Advocate for financial support for transitions of care from the ED to outpatient settings, continued flexibility for telehealth services, and tools to help determine appropriate care settings for patients. Some specific recommended strategies include applying the Transitional Care Management (TCM) CPT codes to the post-ED space. TCM CPT codes are an ACEP-endorsed tool to support emergency physicians in identifying patients safe for discharge, along with reimbursement opportunities targeting health-related social need (HRSN) interventions in the ED.

Education: Provide ongoing education to emergency physicians and their practice groups about the benefits of APMs and the tools available to pursue them.

Collaboration: Promote the adoption of APMs with external stakeholders, including policymakers and payers.

The transition to value-based care has challenges, but the potential rewards are significant. By embracing this new model, emergency physicians can improve patient care and position themselves for success in a rapidly changing health care landscape. The future of emergency medicine lies in value-based care. Emergency physicians can remain leaders in delivering high-quality, cost-effective patient care by taking proactive steps to adapt to this new reality.

Dr. Rehman is an assistant medical director and assistant professor of emergency medicine at Mount Sinai Hospital.

Dr. Wiler is professor in the department of emergency medicine at the University of Colorado School of Medicine.

Dr. Maurer has served as a physician partner with Emergency Medicine Specialists since 2011 and is a leader in a variety of organized medicine entities at the state and national level; she currently works as the CEO of ConsensioHealth RCM.