The healthcare industry has experienced a profound transformation. According to a 2021 FPM Journal article, as healthcare costs spiral higher, more payers are looking to replace the fee-for-service (FFS) system with value-based payment models focused on quality (rather than quantity) care.
Gone are the days when the number of patient visits determined a physician’s success. Instead, there has been a shift towards value-based care, emphasizing the quality and outcomes of healthcare services.
An Academic Medicine article defines value in healthcare as the measured improvement in a person’s health outcomes for the cost of achieving that improvement. Value-based care (VBC) programs incentivize increased quality (measured through a variety of health metrics) and decreased cost (e.g., keeping patients out of hospitals or emergency departments). Prioritizing value-based care over volume can help drive care quality and strengthen patient and financial outcomes.
McKinsey & Company stated that growth in value-based care has accelerated from creating approximately $500 billion in enterprise value today and may be on track to reach $1 trillion as the landscape matures.
Here are some benefits of implementing value-based care for patients and healthcare providers:
1. Quality outcomes
Value-based care focuses on achieving better patient outcomes rather than solely concentrating on the quantity of patients seen. By emphasizing quality over quantity, physicians can focus on delivering effective, evidence-based treatments that improve patient health and well-being.
The National Academy of Medicine described a framework for quality in healthcare that can be used to hold providers accountable in value-based care models. This framework includes the following:
- Effectiveness: Care is based on evidence and is designed to get results
- Efficiency: Providers don’t use unnecessary resources
- Equity: Care does not vary in quality based on personal characteristics such as race, gender, and income
- Patient-centeredness: Each patient’s values, preferences, and needs are respected
- Safety: Treatment does not cause harm
- Timeliness: Treatment is available without long delays.
The value-based care approach strives to ensure patients receive the most appropriate care tailored to their individual needs, leading to better long-term outcomes and overall patient satisfaction.
2. Cost savings and efficiency
While it may seem counterintuitive, value-based care can also result in cost savings for healthcare systems. By focusing on preventive care, early intervention, and chronic disease management, physicians can help reduce the occurrence of expensive hospitalizations and emergency room visits.
Additionally, value-based care encourages the efficient use of healthcare resources, such as appropriate diagnostic tests and procedures, leading to cost-effective care delivery.
A recent McKinsey & Company article added that the path to value creation would likely rest on analytics, standardized clinical practices and operational workflows, and a package of member and physician services designed to reduce medical costs by avoiding unnecessary (or unnecessarily high-cost) practices.
3. Enhanced patient-centered care
Value-based models prioritize patient-centered care, placing the patient at the center of decision-making. Physicians who embrace this approach take the time to understand their patient’s unique circumstances, preferences, and goals.
Physicians can foster trust and promote shared decision-making by developing solid doctor-patient relationships and involving patients in their healthcare decisions. This patient-centered approach improves patient satisfaction and leads to increased treatment adherence and better health outcomes.
4. Collaborative care and care coordination
Value-based care encourages physicians to collaborate with other healthcare providers and staff, promoting care coordination and continuity. Through effective communication and information sharing, physicians can ensure that their patients receive comprehensive and well-coordinated care across different settings and specialties.
This collaborative approach minimizes the risk of medical errors, redundant tests, and unnecessary treatments, ultimately improving patient safety and quality of care. To achieve this care coordination, it is also essential to provide constant training to your providers and staff. Learn more about it on our blog 4 reasons why you should train your staff to improve your practice.
Health Prime’s value-based care services
Partnering in value-based care can help your practice drive clinical and financial outcomes. At Health Prime, we offer value-based care services tailored to your practice that deliver the following:
- Easy-to-adopt patient programs
- Improved care outcomes positioning your practice for success
- Reimbursement opportunities
- No upfront costs
Drive patient outcomes and get reimbursed for care between visits. Our licensed, certified nurses bolster your care team by expanding patient care, increasing reimbursements, and reducing staff strain. Our nationally certified managed care team will lead you in selecting programs and best-practice implementation strategies.
Learn more about our value-based care services, such as Chronic Care Management, Remote Patient Monitoring, Annual Wellness Visits, Behavioral Health Integration, and more, on our website Value-Based Care – Health Prime (hpiinc.com) or contact us at [email protected].
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