After many years of maintaining the status quo, healthcare leaders realized the frequency of patient-provider encounters did not ensure the success of preventative care. Enter value-based care (VBC) — a global initiative to move away from the fee-for-service model with a goal to reduce healthcare costs by making time spent with each patient more productive and results-oriented.
Not only did the fee-for-service model contribute to the exorbitant costs of hospital readmissions, but it also sowed mistrust of healthcare systems among the patient population. By promoting patient-centered care and better coordination in care delivery, everyone involved in healthcare – patients and providers alike – can experience the benefits of value-based care: lower costs and better health outcomes. This article outlines the notable achievements of the VBC revolution now in progress.
How Value-Based Care is Transforming the Patient Experience
In the not-so-distant past, patients held a passive role in healthcare submissively following the lead of providers and sharing minimal information. Patient-centered care seeks to encourage patients to have an active role in the care they receive, moving away from a leader-follower relationship, instead fostering a partnership dynamic.
For example, a patient shares concerns that a drastic change in life circumstances could push them to start smoking again, leading the patient down a path of costly health problems. This gives the clinician an opportunity to intervene by discussing stress management strategies and illustrates how shared decision-making cultivates additional support and more effective solutions.
The following sections will further illustrate the importance of value-based care from the patient’s point of view.
Increased Patient Satisfaction
When patients feel unheard, or that their input does not matter, this creates a chilling effect on communications with providers. Patients will be reluctant to bring up concerns or be forthcoming about factors contributing to their well-being. As part of value-based care, a patient-centered approach encourages shared-decision making where patients and providers work together to create a plan based on realistic expectations.
From increased patient engagement spurred by a patient-centered approach there emerges more information that helps providers to offer better solutions, including personalized treatment plans. This fosters a goal-oriented environment of open collaboration where patients can receive additional support in managing factors that impact care outcomes.
Improved Health Outcomes
The more information a provider has at their disposal, the more informed they can be in shared decision making with patients. Compared to the traditional approach to patient-provider relationships, this approach promotes more early intervention, better management of chronic conditions, and inclusion of social determinants of health (SDOH). Patient-centered care models are holistic in nature, bringing about greater efficiency through data-driven decision making.
VBC also promotes greater collaboration between providers to make care delivery more efficient. For example, if one provider ordered lab work two weeks ago, the other provider will be able to see this instead of potentially ordering the same test again, as a patient may not necessarily be aware that the same test is being ordered twice.
Cost Savings for Patients
One of the primary drivers behind the proliferation of value-based care models is cost savings for payers, but patients can also gain the benefits of a model designed to reign in healthcare costs. Encouraging early intervention, discouraging costly measures such as too many medications, and focusing on cost-effective treatments keeps costs down for payers and patients alike.
Benefits of Value-Based Care for Healthcare Providers
To recruit more providers to replace the fee-for-service model with one based on VBC philosophy, the reasons why value-based care is important must be shared widely among US healthcare professionals. The following sections outline the incentives that motivate providers to follow through with a complete care model transformation from fee-for-service to VBC.
Aligned Incentives and Financial Rewards
A primary driver of the shift to value-based care is performance-based financial incentives. Quantity of patient visits (especially within the Medicare population) assured compensation in the fee-for-service model. However, with VBC as the alternative, revenue comes from incentive payments like bonuses or shared savings through accountable care organizations (ACOs).
VBC is a model based on both recognizing and rewarding excellence in care delivery. Payment based on quality measures and cost-savings cultivates an environment where providers and organizations are accountable for results and are motivated to deliver patient-centered care. This shifts the focus to improved long-term management of chronic diseases and other conditions more likely to incur more healthcare costs.
Enhanced Care Coordination and Collaboration
A side benefit of VBC is how it propels all stakeholders in patient outcomes to increase their efforts, including the patients themselves. Individual providers serving the same patient in a VBC environment are now incentivized to promote care effectiveness through collaboration rather than practicing in silos. For example, bundled payments compensate multiple providers for their involvement in a single episode of patient care delivery.
The benefits of VBC from a collaborative perspective are cutting back on unnecessary tests and procedures, enhancing the patient experience through effective communication, and an alignment of objectives that supports all in reaching their targets to be paid based on quality measures. Ideally, better care coordination benefits everyone involved: payers, organizations, health systems, providers, and patients.
Summary: The Net Benefits of a Value-Based Care Revolution
Traditional fee-for-service care models fell short of preventative care that could assist in controlling care costs. Value-based care (VBC) is an alternative model that incentivizes care quality performance by awarding bonuses and financial incentives generated by controlling costs (shared savings).
Ideally, payers, organizations, health systems, providers, and patients will all experience the benefits and achievements brought about by a VBC model:
- Patients: Such a transformation invokes a patient-centered approach to care that not only increases patient satisfaction, but also compels patients to have a more active role in their outcomes.
- Organizations, practices, health systems, and providers: Care teams work together to implement a care model where incentive payments are earned through better performance while fostering patient retention through increased patient satisfaction. This can also promote increased job satisfaction.
- Payers: As providers and patients embrace the VBC model, payers achieve their goals of controlling healthcare costs.
Experience the Benefits of Value-Based Care Transformation by Joining Forces with Expert Consultants
As more healthcare organizations change over to a value-based care structure, others may feel compelled to follow suit. Medical Advantage has extensive experience in value-based care implementation and initiatives. As you close the chapter on fee-for-service, and embrace the value-based care model, our experienced consultants are dedicated to your success, assisting with every aspect of the transformation. Contact us today to learn how your organization can seize the benefits of value-based care.
