Value-based care is a model that incentivizes healthcare organizations to improve patient outcomes and reduce costs. This can help to benefit patients, payers, suppliers and society as a whole.
Physicians can gain financial rewards for participating in value-based contracts. Patients will have better access to information, which can help to keep them on track with their care.
Lower Costs
In value based care, providers are incentivized or rewarded for meeting specific performance goals that payers and commercial health insurers set. These goals typically seek to improve quality, cost, and equity measures.
As a result, providers who focus on patients’ long-term well-being are rewarded rather than merely compensated for treating them with expensive drugs and procedures. This encourages them to promote healthy habits that can significantly reduce their overall medical costs throughout a patient’s lifetime.
This can lower healthcare spending by reducing costly hospital admissions and emergency department visits. To achieve these objectives, the best value-based care groups often supplement physicians with nurse practitioners, pharmacists, community health workers, and other clinical specialists that can serve a patient’s needs more efficiently. This also enables them to use data and analytic insights to optimize the cost of their care pathways. This can include prescribing generic medications in preference to branded ones and choosing more affordable diagnostic tests over more costly ones.
Reduced Medical Errors
Medical errors are a major concern in the healthcare industry. They not only cost the country millions, but they can also cause serious injuries or even death. Value-based care incentivizes doctors and hospitals to focus on quality and reduce medical errors.
Moreover, clinical performance management encourages providers to provide better patient outcomes with proactive preventive measures. This enables patients to manage chronic diseases and lead healthier lives while saving costs in the long run.
Providers are encouraged to improve quality through nonfinancial incentives such as increased patient satisfaction and more efficient care delivery. This includes upgrading their health IT to enable better data analytics, implementing telehealth solutions and improving patient engagement.
With value-based care, payers control costs and spread risk by bundling payments that cover a patient’s full care cycle or for chronic conditions covering periods of a year or more. This helps them to reduce their expenditures by lowering claims costs and increasing revenue streams.
Increased Patient Satisfaction
The traditional fee-for-service model incentivizes healthcare providers to perform as many procedures and tests as possible. This succeeds in driving up healthcare costs but doesn’t improve patient outcomes. Value-based care models shift the focus away from quantity and toward quality.
Moreover, the bundled payment model reduces the amount of administrative waste between payers and providers, allowing each party to focus on its core mission of delivering better patient outcomes. This model also helps ensure a high-quality patient experience by focusing on transparency and putting patients in control of their health.
Having all their care in one place, patients can easily monitor their health and maintain healthy habits to avoid costly procedures or medications. This will improve a patient’s overall satisfaction with their healthcare plan. Ultimately, patients are happier and healthier when they can manage their conditions themselves and spend less money on unnecessary treatments and visits. Managing a disease like diabetes or high blood pressure requires more time, energy, and resources than treating a chronic illness that progresses over time.
Increased Efficiency
Value-based care models encourage a team-oriented approach to healthcare. With these programs, payers and providers share the cost risk and reduce overlapping administrative costs through bundled payments. This also helps cut out wasteful spendings, such as on excessive or unnecessary procedures and tests.
Patients can also benefit from these streamlined systems by accessing and viewing their healthcare information easily through electronic medical records (EMRs). This allows them to make more informed decisions about their healthcare, which can lead to better health outcomes while lowering overall spending.
As a result of valuing patient outcomes, it’s more likely that suppliers will align their prices with those outcomes. This will benefit the healthcare industry and its patients, especially with prescription drug prices rising. It will also promote more transparency in the market, which can help keep costs down for everyone involved. This will ultimately improve society’s overall health and well-being.
