What is Value-Based Care?

Value-based care describes a practice that health care professionals sometimes use that is designed to focus on providing a higher quality of patient experience and provider care at a lower cost. It focuses entirely on what the patient individually values most. These programs pay providers based on quality of care, rather than quantity.

In value-based care, doctors and other health care providers work together in managing the health of a patient, working towards the individual’s personal health goals. It is a healthcare model aiming to be healthcare more proactive, more preventative of potential problems, while keeping the experience for the patient as efficient and cost effective as possible.

For example, doctors might coordinate with each other so that you only need to go into the clinic once. This approach to care reduces the costs of the patient and increases the speed at which the patient receives care. In value-based healthcare, doctors are prompted to talk to each other to coordinate care and address the needs of the individual receiving care.

Why is Value-Based Care important?

It is a common goal between patients, providers, employers, plans, and the government to improve the health of a patient while reducing the costs of care. Value-based health care aligns the outcome and prices of heath care so well, shortly after the concept was introduced in 2006, health economist Uwe Reinhardt described it as “a utopian vision.” While there has been expressed concern over the challenges of transitioning to the methods of value-based care, it is a vision highly regarded and striven for by many.

Achieving better outcomes in your health also reduces spending and decreases the need for ongoing care. By focusing on the specific health needs of a patient and improving the speed and quality of their care, value-based health care reduces the need for more care. A patient who receives care for a condition that can worsen reduces the need to spend more on care in the future.

What does it look like for the patient?

In value-based care, health care providers recognize that each person is unique and can experience improved health outcomes through person-centered, coordinated care.

According to CMS, patients who receive value-based care may notice significant improvements to their health care experience, including:

• An easier time navigating their care with the help of an assigned care coordinator who will contact them between medical visits to see how they are doing following a procedure, answer their questions, or problem-solve any issues they encounter following treatment.
• Access to training or other educational resources about their health issue(s).
• More options in how they receive care or how to communicate with their provider.
• An opportunity to participate in a disease prevention program, such as for diabetes or heart disease.

Some say that Value-based care can lead to fewer hospitalizations, readmissions, and emergency room visits. The model is designed to focus specifically on the health equity of an individual, or the attainment of the highest level of health. Value-based care advances health equity by:

• Putting focus on the health outcomes of every person and measuring the impact and results of the focused care.
• Encouraging health care providers to screen for social needs and work with individuals to develop personalized treatment plans that can address each person’s unique needs — such as connecting them to a local food bank, engaging with interpreter services, or arranging transportation or other accommodations.
• Requiring health care providers to monitor and track outcomes across populations to assess for disparities and intervene as necessary to help close gaps in access or care.
• Engaging with providers who have historically worked in underserved communities and providing necessary resources and supports to meet this health equity goal.

All payers, including Medicare, Medicaid and Private Insurance, are moving towards value-based care. If you are in need of Medicare or Health Insurance and are interested in receiving value-based care, fill out our form by clicking the button below and speak to one of our experts about getting the care that you need!