The concept of value-based healthcare (VBHC) was introduced in 2006. Although it is still fairly new, the idea is rapidly growing in the healthcare industry and being adopted by health providers nationwide.
Basically, VBHC proposes to restructure the health care systems with the goal of value for patients (or health outcomes). Thus, providers need to improve their health outcomes to enhance value.
While the practice was well-received as the industry’s future, a 2019 Washington Post survey with 364 US healthcare executives found that only a third of them were experimenting with some form of value-based care.
Let’s take a look at what value-based care means and why providers should care about this approach.
Value-based Care at Its Simplest
In short, it’s already known that healthcare systems are spending more without achieving better health outcomes. The system used in hospitals and clinics today is based on volume, not patient results.
The traditional “fee-for-service model” works as follows: every time a patient has an appointment with a doctor, or needs to perform any medical test or procedure, their insurance provider pays for every step in the chain. This payment occurs even if the diagnosis or procedure was not successful.
In turn, the concept of value-based healthcare proposes better patient outcomes to lower the costs of care. The digital systems adopted by most clinics and hospitals allow support for the systematic measurement of patient-reported outcomes.
This way, doctors and hospitals will be paid based on outcomes, not on the number of patients seen or procedures done.
Theoretically, the benefits of the value-based healthcare system are unquestionable:
- Patients spend less money for a better experience.
- Providers achieve more efficiency and quality, which leads to greater patient satisfaction.
- Value-based payments keep costs under control and prevent resource overuse.
- Society as a whole becomes healthier by spending less.
But since 2006 when the idea was suggested, value-based care might be changing as a concept or how it’s implemented.
Until today, providers and healthcare institutions face a series of challenges to implementing the system, such as:
- Resistance of clinic administrators, providers, and system payers to abandon the fee-for-service model.
- The difficulty of establishing clear definitions for patient-reported outcomes and also for measuring performance.
- Outdated or non-interoperable digital systems that do not allow access to patient data.
In the face of these difficulties, how can one remain true to the goal of providing higher-quality care?
Delivering Value-Based Care
There’s a long road ahead for value-based care to be adopted on a large scale. But healthcare providers can best provide this kind of care by gradually adopting some of these practices:
Establish a Value-based Care Model
By adopting a value-based care model, providers are compensated based on patient outcomes. To do so, it’s first necessary to determine what part of the care cycle will be affected (Diagnosis and treatment? Follow-up?).
Then you will have to determine which patient outcomes will be adopted as a reference. The International Consortium for Health Outcomes Measurement (ICHOM) has already developed some validated outcome sets, with indicators that can be adopted by health providers that are just starting.
Record and Analyze
You need to digitize your clinic processes to better understand the health of your patients. By collecting and analyzing patient data, you can more easily identify problems or gaps in care and measure patient outcomes and costs.
This will also make it easier to find out what treatment plans are more effective. Ultimately, you’ll be able to determine the best care plan for that specific condition, saving you time and money in the process.
Ensure Patient-Provider Relationships Are Long Lasting
Patients are usually seen by different health professionals during the same treatment. To ensure the utmost care, it is best to emphasize the relationship between patient and provider. A recent research reiterates that patients prioritize and value their individual relationships with these professionals.
Furthermore, a physician who follows a patient’s clinical condition from beginning to end is better prepared to provide better care than several physicians who only show up at some stage and have to review all the patient’s details from scratch.
Create a Long Term Care Plan for Patients
The traditional fee-for-service model continues to be used by health providers, but it doesn’t have to be that way. When you can determine in advance the costs for the entire treatment, you can adopt other forms of payment that are more economical and convenient for everyone.
For example, the bundled payment system predetermines the total costs for a patient from start to finish instead of charging for each individual service.
To implement this kind of system, you need to go back to the second step and digitize your processes. The use of electronic health records (EHRs) allows you to keep track of how the patient’s health needs to be addressed.
Reviewing the functions and advantages of using EHRs allows you to offer more personalized healthcare.
Everything Leads to Value-based Care
Although it is a long-term goal, the concept of value-based healthcare is here to stay. The system will allow reducing health costs while producing better results.
The electronic health records of each patient help in this scenario by eliminating the need for repetitive and unnecessary exams or procedures. With an integrated digital system, health providers can exchange information more quickly to determine the best treatment.
In the end, everyone wins: patients receive better care while health providers act more efficiently and with less wasted effort and money.