There are many benefits of moving to a value-based care model. These include improved patient outcomes and lower costs for all parties involved.
Traditionally, healthcare providers have been paid for the number of services they perform rather than the quality of those services. This has led to healthcare waste, which accounts for 30% of all healthcare expenditures.
Better Care Coordination
Value-based care models focus on improving patient outcomes and helping patients recover from illnesses and injuries more quickly. This allows patients to avoid chronic disease, which can be costly and time-consuming.
Unlike fee-for-service models, value-based models pay providers based on quality rather than quantity of visits, which can lead to less waste. This helps reduce healthcare costs while increasing accountability among doctors, hospitals and healthcare systems.
Care coordination is a critical component of value-based care models. This involves creating proactive care plans and working with patients to address their social determinants of health to help improve their overall well-being.
When done correctly, care coordinators can be an invaluable resource for patients, especially those with complex medical needs and chronic conditions. Communicating regularly with patients and providing interactive education resources can help them better manage their health and prevent disease.
Research has shown that care coordination improves patient outcomes, including the HEDIS quality scores. The study found that patients who experienced improved care coordination had better clinical performance scores across 7 of the 13 HEDIS measures, while those who did not share it had worse scores.
Increased Patient Engagement
Patient engagement is a fundamental element of a value-based care model. It improves outcomes and reduces costs by empowering patients to become co-producers of their health and well-being.
A healthcare organization that is more advanced in its patient engagement strategy invests in processes and technologies that proactively identify and address the needs of patients throughout their care journey. These organizations then prioritize extending their reach across all levels of care to link disparate data and create an integrated experience.
The best patient engagement strategies include a holistic approach that focuses on simplification and communication. They also have psychographic profiling, which helps providers understand and communicate with specific patient groups. By targeting these psychographic segments, providers can better tailor patient engagement strategies to their unique behaviors and thoughts.
Better Patient Communication
Regardless of your chosen care model, communication is essential in patient care. It helps you understand your patients' thoughts, making you more likely to provide accurate and thorough treatment plans.
In a healthcare setting, communication is especially critical because errors can be deadly. Studies show that two out of three patients leave the hospital without knowing their diagnosis, and 60% leave a doctor's visit unclear about medication or follow-up instructions.
To improve patient communication, medical professionals can use a range of strategies. For example, they can ask open-ended questions to encourage patients to explain their concerns.
These communication techniques can also help patients feel more comfortable with their care. They can also make it easier for medical practitioners to adapt their language to suit patients' needs, leading to more effective interactions.
As a premed, improving your communication skills is one of the best ways to prepare yourself for clinical rotations and your career as a physician. By learning more about how to talk with patients and practicing these techniques, you can ensure that your patient relationships will be strong and that you will have excellent outcomes.
Better Data Analysis
Value-based care models aim to improve patient outcomes by leveraging incentives and payment structures that motivate providers to focus on high-value care. They are also designed to lower national healthcare expenditures.
To succeed, value-based care providers must have better data analytics capabilities. They need to gain visibility into their attributed populations' challenges and utilization patterns to identify areas where they can improve.
This is challenging to achieve, particularly for organizations accustomed to managing their business based on fee-for-service (FFS) reimbursements. Many healthcare providers have competing priorities that may stymie their ability to invest in data analysis.
Some value-based care models include upside risk, in which providers receive a share of savings if they meet quality, cost, and equity benchmarks. Others have downside risks, in which providers lose money if they fail to meet these goals.
Both types of programs can be a success for specific provider organizations, but they can also create financial problems for providers uncomfortable with risk. For example, if the downside risk is too severe, it could discourage risk-averse hospitals from joining value-based care models in the first place.
Better Patient Outcomes
Ultimately, better patient outcomes improve health and reduce costs. Unlike the traditional fee-for-service model, value-based care models reward providers for helping patients become healthier and less likely to develop chronic diseases or other health conditions.
For example, people with diabetes can work with their doctors to stick to a healthy diet and exercise plan and keep blood sugar under control. This preventive care can significantly lower the need for costly medical tests, ineffective medications or unnecessary procedures.
But getting patients to follow these recommendations can be difficult. A
One reason is that many value-based groups contract with narrow networks of specialists and medical centers, often based more on cost than quality. These small specialist networks can cause significant delays in accessing care and sometimes even negatively impact health outcomes.
In a value-based system, healthcare suppliers can align their prices to patients' health outcomes to be more profitable. This can be especially appealing as national health expenditures on prescription drugs continue to rise.
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