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What is Value-Based Healthcare?

The rising cost of healthcare across the country is a top concern for most Americans from patients to providers. In the last several years there has been a shift in the delivery of healthcare pay models from the traditional fee-for-service (FFS) model to value-based. Value-based healthcare is a healthcare delivery model in which providers, including hospitals and physicians, are paid based on patient health outcomes. Under value-based care agreements, providers are rewarded for helping patients improve their health, reduce the effects and incidence of chronic disease, and love healthier lives in an evidence-based way.

In comparison to a fee-for-service approach, providers are not paid simply on the service they deliver but rather in the value they deliver and add to the lives of their patients. The Value-based care model gives patients quality care and peace of mind knowing their care plan is intentionally structured to add value to their lives, health, and well-being.

Benefits of Value-Based Healthcare Delivery

The benefits of a value-based care system extend well beyond the patients and the providers – it impacts the patients, providers, payers, suppliers, and society as a whole. Below is a breakdown of the benefits for each category.

  1. Patients spend less money to achieve better health and receive a ethical treatment plan centered around improving their health. Managing chronic diseases or conditions such as diabetes, high blood pressure, cancer, COPD, and obesity can be costly, and stressful. Value-based care focus on helping the patients recover from illnesses or injuries more quickly or possibly avoid it in the first place. Because the pay structure is revolved around the progress of the patient, they face fewer doctor’s visits, medical tests, and procedures while spending less money on prescription medication for both short-term and long-term healthcare.
  2. Providers achieve efficiency and greater patient satisfaction. While time may increase for care, prevention-based patient services, they will spend less time on chronic disease management. Quality and patient engagement measures increase when the focus is on value instead of volume. In addition, providers are not placed at the financial risk that comes with FFS payment systems. Even for-profit providers, who can generate higher value per appointment, stand to be rewarded under a value-based care model.
  3. Payers control costs and reduce risk. Risk is reduced by spreading it across a larger patient population. A healthier population with fewer claims translates into less drain on payers’ premium pools and investments. Value-based payment also allows payers to increase efficiency by bundling payments that cover the patient’s full care cycle covering periods of a year or more.
  4. Suppliers align prices with patient outcomes. Suppliers benefit from being able to align their products and services with positive patient outcomes while reducing cost.
  5. Society becomes healthier while reducing overall healthcare spending. Less money is spent helping people manage chronic disease and costly medical emergencies and hospitalizations. In a country where healthcare expenditures account for nearly 18% of GDP, value-based care has the promise to significantly reduce overall costs spent on healthcare.

Although it will take time, the future of the value-based care system will dramatically lower costs across the board and deliver better care to patients across the country. Here at Pure Vita, we believe in value-based care. We are able to implement this belief through reducing costs and connecting data 24/7.

Resources:

https://catalyst.nejm.org/doi/full/10.1056/CAT.17.0558

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