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You may have heard the term "value-based care" before, but what does it mean practically for you as a patient? Read on to learn the many advantages of this approach and why you should consider seeking a provider that practices value-based care.
What is value-based care?
At its core, value-based care is about improving health outcomes and reducing costs. Put another way, it's about delivering the right care at the right time in the right place.
Traditionally, the healthcare industry has operated under a fee-for-service model where providers are paid based on the number of procedures they perform or patients they see. In a value-based care model, providers are paid by their ability to improve health outcomes, reduce costs, and increase patient satisfaction.
Value-based care also focuses on proactive, preventative health measures to keep patients from getting sick in the first place. By preventing disease and identifying and treating chronic conditions in their earliest stages, the healthcare system is more effective and less expensive overall.
Here are four ways patients experience clear benefits from value-based care:
Coordinated care
Value-based care focuses on building relationships between patients and their care teams across multiple disciplines and specialties. For example, patients with diabetes might work with dieticians, licensed clinical social workers, nephrologists, pharmacists, and others to manage all aspects of their condition. This approach also works across multiple care systems (hospitals, clinics, telehealth etc.) to deliver collaborative and seamless continuity of care. Patient health data is shared as appropriate to ensure information is accessible, accurate, and available whenever and wherever it is needed – regardless of the provider or care setting.
As Cleveland Clinic puts it, "Instead of going to several institutes to get care, you work with one integrated team that already knows you and your health background."
Patient empowerment and satisfaction
In a value-based care model, patients are encouraged to play a more dynamic role in their own care and be involved in key decisions. Providers focus on education so that patients fully understand their conditions and treatment plans. New technologies like telemedicine and online health data patient portals are also utilized so that patients can access and share their information easily.
According to Aetna, here's what can happen when healthcare is coordinated and efficient, data and technology are utilized effectively, and patients are engaged in care.
- Individuals have a better experience navigating the healthcare system.
- More people get preventive services like colonoscopies, mammograms, and flu vaccinations.
- Risk factors and early disease are more rapidly detected and addressed.
- Chronic diseases, like high blood pressure, diabetes and kidney disease are more likely to be under control.
- There are fewer emergency room visits, hospitalizations, and re-admissions.
Reduced costs
Reducing the cost of healthcare is about being aware of the aspects of care that are the most expensive (i.e. emergency room visits, hospital readmissions, brand-name medications, etc.) Value-based care systems work to protect patients from unnecessary spending. Patients won't always see those cost savings translate to immediate reductions in their insurance premiums, but they can see an immediate difference in their out-of-pocket costs by choosing to get their care from organizations that practice value-based care.
Cost reductions come from a variety of places including:
- Fewer unnecessary or duplicative tests and procedures.
- More prescribing of generic medications when possible.
- Better management of chronic conditions, leading to fewer complications.
- Appropriate use of walk-in clinics and urgent care sites instead of emergency rooms.
Better health
Providers and healthcare systems that participate in value-based care programs with insurance companies are incentivized to improve the quality of patient care. These systems must report on specific quality measures and demonstrate how their actions have resulted in better health outcomes. This reporting helps providers identify gaps in care like a missed follow-up appointment or screening. Care and health outcomes markedly improve when providers proactively anticipate patients' health needs rather than treating only the presenting illness.
For more than a decade, Revere Health has been a national leader in practicing value-based care. Visit www.reverehealth.com to learn more and find your next provider.