What is value-based care?
The value-based care model prioritizes the quality of care over the quantity of care. It’s a marked difference from the traditional fee-for-service model. Instead, it is a method of reimbursing providers based on patient outcomes.
Rather than paying (and thereby incentivizing) care providers for the number of tests performed or the number of treatments delivered, value-based care prioritizes the overall quality of a patient’s health.
The value-based care model works as a collaborative effort among various members of a team, which may include doctors, nurses, specialists, pharmacists, and social workers, among others. Each member of the team is working toward helping the patient manage their health. The team may be assisting in an acute illness, or more likely simply helping to manage a chronic condition. The result is the overall improvement of the patient, who is treated with an integrated method of care instead of as a case of disparate assessments and treatments. Through this method, the patient also becomes a part of the team, invested in their own care.
The goal of value-based care
Improved quality of care and the promotion of overall wellness for the population as a whole (also known as population health) is the main goal of value-based care. Alongside this goal is enhancing the patient experience and their satisfaction with their care. This is achieved through more time spent listening to patient concerns and addressing their needs. But as the name “value-based” implies, lowering costs is a critically important component of this health care delivery model as well.
When the health system’s focus is centered on improving patient health, care providers are no longer incentivized to rack up volume. Instead, they can begin to increase the efficiency of care. Unnecessary tests or diagnostic procedures are reduced or eliminated, lowering costs for providers, payers, and patients.
And with less time spent on billing and other administrative drains, primary care practices are able to better engage with patients, spend more time with them, and provide a more effective and caring experience.
In turn, patient satisfaction increases. Patients become more engaged and more proactive with managing their health. Their health, in turn, improves, reducing drag on the primary care provider and permitting for a deeper and more meaningful system of care that can provide preventive and ambulatory care instead of needing to divert resources to handling acute illness.
Additionally, the integrated approach helps patients learn to manage the many different aspects which have interplaying effects on health, from diet to comorbidities to social concerns. This feeds into the promotion of health and wellness as well, improving patient health and, when taken in aggregate, the health of the population as a whole.
The benefit of value-based care
Successfully executed, value-based care creates a health care delivery model that is focused on improving patient health instead of increasing billings. Patients enjoy a health care experience that is personal, engaging, and most importantly, effective. They enjoy more time with their primary care provider, able to ask questions and gain a deeper understanding instead of feeling like a number.
Primary care providers are able to get back to what they do best: helping people heal and remain healthy. Even insurance companies are able to reduce costs when a value-based model is used, because there are fewer unnecessary tests and treatments, and the care that is covered is more effective at reducing illness and poor health in the future. The multi-faceted care possible with a value-based care system may even be able to reduce the incidence or severity of chronic illness, which is costly both in terms of health and financially.
With value-based care, providers can take advantage of data to provide more effective care while reducing costs and managing risk. This can allow them to better capture incentives, provide appropriate levels of staffing, and support a healthy population to boot.
Health Care Advantage offers a way for Medicare-eligible adults to find the value-based care providers they’re looking for. Contact us to learn more.