Value-based care (VBC), a healthcare payment model, puts a heavy emphasis on the overall health of a patient rather than what they may be presenting at a face-to-face office visit. It focuses on providing high-quality, cost-effective care to patients. This model is different from your standard fee-for-service reimbursement model that encourages providers to prioritize quantity of service over quality. This oftentimes results in higher costs and less personalized care for patients.
For healthcare providers, it’s important to identify what preventive services a patient needs long-term, with a heavy emphasis on the overall health of a patient. Under a value-based care contract, providers are reimbursed based on quality outcomes. One way is to encourage coordinated care using EMR (electronic medical record) data. Before seeing patients in the office, they can check EMRs for discrete data fields to document quality measures and see where gaps in care are. After identifying gaps, they can provide powerful insights and quality outcomes for your entire population.
Accountable Healthcare Organizations (ACOs), for example, are networks of providers that work together to coordinate care, typically for Medicare patients. ACOs strive to provide the right care. When successful, not only do we improve population health, but ACOs share in any savings generated from reducing costs of care. Integrated Healthcare Networks (IHN), and the Medicare Shared Savings Plan (MSSP) are other networks that fall under value-based care.
If providers can easily identify high risk patients and solve their care needs, we can keep healthy patients out of the office. Thus, tackling some of the common challenges we see in healthcare today like physician, nursing, and staff burnout.
Another important part of value-based care is the use of data and analytics to make informed decisions in service of better healthcare. Providers are encouraged to collect patient data, analyze, compare, track, and identify areas for improvement. How can leaders from top ACOs and other health systems deploy data-driven strategies to tackle healthcare's greatest challenges? Healthcare leaders study data to improve a community’s health. Researchers utilize data to develop new treatments. Data can help patients manage chronic conditions, and get the right care, when they need it the most.
Value-based care incentivizes healthcare providers to focus on quality outcomes while earning more savings from their risk-based contracts. It’s a win-win payment model when executed properly. Are you a healthcare provider looking to optimize finances and patient care? Learn about how we help.