Here’s a novel approach to improving a healthcare system – taking a proactive approach, rather than a reactive one, to improve the quality of healthcare for patients by preventing problems before they arise.
That’s the concept behind value-based care, which focuses on prevention in order to lower the need for expensive medical testing, ineffective medications, and unnecessary procedures. In such a system, healthcare providers are paid based on patient outcomes instead of the “fee-for-service” model, essentially rewarding them for helping patients become healthier, which cuts costs for everyone.
Take, for example, someone who has been diagnosed with diabetes. Under a value-based care model, the patient would work with an integrated team of physicians to maintain a healthy diet, adopt an exercise plan, and keep their blood sugar under control. Since patient data is shared and care is coordinated, it is easier to measure the patient’s healthcare outcome.
Value-Based Models for Healthcare
The five value-based models are:
- Patient-centered medical home (PCMH) – This model integrates primary, specialty, and acute care. It’s a team approach led by the patient’s primary care physician (PCP) who shares electronic medical records (EMRs) with all doctors on the coordinated care team, so they all have access to the same patient data.
- Accountable care organizations (ACOs) – This model specifically caters to Medicare patients by enabling hospitals, doctors, and other healthcare providers the means to work together to provide the most effective solutions for the lowest cost.
- Bundled payments – With this model, payments are lumped together – rather than charging patients for each individual service – and multiple providers are reimbursed together instead of paid individually.
- Capitation – Designed to reward cost-effective and high-level healthcare rather than volume, capitation involves providers taking financial responsibility for the wellbeing of a certain patient population. Member patients pay an annual premium, which is combined and used by the provider to care for the population. Instead of getting reimbursed by insurance companies for each provided service, providers spend the funds in a way that best serves the health of the population. By paying more for patients with a history of medical issues, for example, providers are incentivized to keep individuals healthy and prevent disease.
- Shared savings and shared risks – Under this model, payers have a budget for costs associated with care and delivery of care. If a provider’s costs fall below the set budget, they share the savings. On the other hand, providers have to pay for any care-delivery costs that exceed the set budget.
The Benefits of Value-Based Care
Value-based care offers several key advantages, including:
- Cost reduction – By focusing on prevention and recovery, value-based care ultimately results in less spending as conditions are more easily managed or avoided, requiring fewer medical visits, tests, and procedures, and more affordable medications. Hospitalizations and medical emergencies are reduced, and less money is spent on chronic disease management.
- Greater patient satisfaction – By focusing on value rather than quantity and prevention instead of chronic disease management, value-based care programs improve the quality of healthcare. This results in higher overall patient satisfaction.
- Reduction in medical errors – A value-based approach to healthcare helps reduce medical mistakes that are often the result of ineffective or harmful treatments.
- Better access to information – Shared data in one place helps keep patients better informed and enables them to take proactive preventative measures while spending less.
- A beneficial focus on prevention – A value-based care program encourages healthy lifestyle habits.
Value-Based Care for Seniors in Central and South Florida
Palm Medical Centers is a Medicare health services provider that excels at providing high-quality and value-based preventive, as well as primary healthcare services that can help keep you healthy as you age.
We have 22 convenient locations throughout South and Central Florida, where we provide a wide range of interdisciplinary healthcare services. In addition, we are an affiliated ACCESS site that assists recipients in social and government programs. Among other services, the ACCESS and Social Worker team guide patients on Medicare and Medicaid application and renewals.
For more information about our value-based, preventive health services or to make a doctor’s appointment, please contact the medical center closest to you.