What Is Value-Based Care?


A health care system that focuses on patient-centered outcomes is known as value-based care. Developed by Elizabeth Olmsted Teisberg and Michael Porter in 2006, this approach aims to create a more efficient health system that maximizes value-based care outcomes while minimizing costs. Although some people are skeptical of this new approach, there are many benefits.  This article will answer the following questions; what is value-based care, what it means for providers?

Patient-centered organizations

Value-based care models promote a patient-centered approach to health care. This model emphasizes the patient’s needs, wants, and values and integrates those into clinical decision-making. Such models can boost patient satisfaction, enhance providers’ reputations, and increase financial margins. This model has been implemented in various health care settings, including primary care. The first step is shifting from traditional care models to patient-centered care. This shift is not a one-time event, and conventional hierarchies do not define the patient-centered care model. Instead, it takes organizational and administrative changes. For example, a hospital might enable new appointment scheduling systems, simplify online bill-paying, support clear hospital wayfinding, and streamline call-center processes.

Measuring outcomes

Measuring outcomes in value-based health care are crucial to improving the quality of care and driving cost-efficiency. This requires new methods of measuring patient outcomes, including quality and safety measures. To make these new methods as effective as possible, health systems should review current guidelines and understand the definition of patient outcomes. Then, they should integrate the three essentials for outcome measurement. These elements are described below.

Ultimately, the success of value-based care depends on the ability to measure outcomes. Using data to measure patient outcomes will help healthcare organizations define their mission and goal, inform the composition of an integrated care team, highlight cost-saving value, and motivate clinicians to improve their skills. It will also help the organization shift from volume-based payment to outcomes-based payment, a key goal of value-based care. Outcome-based measures will also facilitate risk-sharing for new products and treatments.

Shared savings

A common question about value-based care is how to incorporate shared savings programs into your daily practices. Shared savings programs reward physicians and hospitals for improving patient outcomes and reducing unnecessary spending. In addition, they reward physicians for improving patient satisfaction and creating a sustainable healthcare delivery system. Here are some tips to help you get started. These components are essential to ensuring a successful partnership between physicians and payers.

CMS will pay physicians who participate in ACOs through shared savings programs. While this program is similar to bundled payment programs, the difference is that the payments are for a population rather than a single episode of care. In addition, physicians and hospitals will share in the insurer’s protection by reducing costs under shared savings. However, the costs associated with bundled payments are lower, so physicians are more likely to opt for ACOs.

Shared risk

Shared risk has become a popular choice among the value-based care models, particularly among payers. This payment model is designed to provide incentives for providers to improve cost performance while sharing the savings generated by shared costs. In addition, this type of payment model allows payers and providers to define their expectations and share in any savings. However, the shared risk is often misunderstood as a risk transfer between providers and payers.

A new study has shown that shared risk is widely accepted in California. According to the IHA-funded Atlas, nearly half of the commercially insured population in Southern California was treated by providers who shared some or all of the cost. However, the same analysis shows that full risk models were embraced by only 9% of commercially insured patients in Northern and Central California. That finding is alarming. In addition, shared risk has also been associated with increased quality and efficiency, allowing hospitals to focus more on patient care and reducing costs.

Cost-effectiveness

A key aspect of value-based care is improving price transparency by focusing on the total cost of care rather than just the cost of a single treatment. Of course, obtaining such information at the patient level is difficult, but knowing the costs of medical care empowers patients to make wise financial decisions. This approach also shows the value of preventive care, as early detection of problems often results in a lower cost and less impact on the patient.

While value-based care strategies are typically designed in the boardroom, they must be implemented at the point of care – often the primary care practice. According to Michael Supino, CEO of Midland Medical, a primary care practice in Oakland Park, Florida, obtaining buy-in from staff and aligning incentives with their day-to-day responsibilities is the key to success. In addition, achieving buy-in and educating staff on the model is vital to success.


Like it? Share with your friends!

0 Comments

Your email address will not be published.

Mommy Iris

I'm a lifestyle and mommy blogger from the Philippines. Pinay Ads was created to share bits and pieces of my life and my family. I have a wide array of interests that include entertainment, movies, music, gadgets, traveling, food, baking, and more. So, I hope you’ll stick around and enjoy reading!