The value-based system seeks to improve the quality of care for patients. This individualized approach to healthcare prioritizes best practices such as provider cooperation, error prevention and overall patient satisfaction.
Learn how the switch to a value-based care system brings benefits for your healthcare center and the patients you serve.
What Is Value-Based Care?
Value-based care is a newer approach to the delivery of medical services. At its core, it's simple, but it has the potential to reshape the healthcare industry. The idea is to provide quality care and positive patient outcomes rather than focus on the quantity of services.
A value-based system is more proactive and less reactive. It focuses on personalized services, overall wellness and preventive treatments. If a patient stays healthy, this simplifies their healthcare needs and reduces costs for everyone.
When a healthcare system switches to a value-based approach, it makes proactive changes focused on patients. Some of the main differentiators of value-based care include:
- Patient-centered efforts.
- Data-driven insights, using patient records to find what works and what doesn't.
- Cooperation among the entire medical team who share a clear vision.
- Shared patient information with a functional IT system
- A focus on wellness programs and preventive screenings.
- Reimbursement models that reward quality patient care over quantity.
5 Benefits of Value-Based Care
So, why is value-based care important for patients, providers and populations? A value-based care model focuses on best practices and better patient outcomes, aligning healthcare teams with their primary purpose — helping people get better. When the patient is at the heart of every decision, there are clear and discernable advantages.
Here are five benefits of value-based care.
1. Improved Patient Satisfaction
The number-one goal of value-based care is to help patients. Patients can tell the difference when the focus is on quality over quantity of services. Individualized care allows them to feel seen and heard. Preventive services help ward off issues before they become chronic concerns. The result — improved patient satisfaction.
2. Cost Reduction
A healthier population equals overall cost reduction — for patients, providers and payers. The current focus of the healthcare system is chronic disease management. Conditions like diabetes, cancer and high blood pressure run rampant, consuming time, energy and money.
The focus of value-based care is disease prevention. When conditions are manageable or avoided altogether, this means:
- Rarer medical visits, tests and procedures.
- Less drain on a provider's time and resources.
- Fewer insurance claims.
3. Reduced Medical Errors
Medical errors are a significant concern for patients, healthcare centers and insurance companies. Because of a lack of communication or a shared patient information network, healthcare teams spend money on redundant, ineffective or potentially harmful treatments.
Value-based care seeks to reduce medical errors through cooperation among providers. Functional IT systems and shared patient records ensure better communication.
4. Prices Aligned with Patient Outcomes
New value-based reimbursement models focus on patient outcomes and lowering overall costs. When clinicians focus on positive results, they can align more fully with their patients' goals and wellness. Value-based care frees providers up to deliver services that make a difference and ensures they are compensated for doing what matters.
5. Informed Patients
Shared patient data is beneficial to everyone, including patients. People should not be left in the dark regarding their health. Electronic health records allow patients to stay on top of their wellness program. When patient records are in one place and accessible, individuals can fully grasp their health situation. They can be proactive, utilizing preventive measures and taking steps toward better overall wellness.
How Can Value-Based Care Save Money?
Saving money does not mean denying certain services. Value-based care ensures patients receive the right level of care at the right time and place. When providers, patients and payers are aligned with a common goal, reduced costs are the natural outcome.
The preventive focus of value-based care addresses the risk factors that lead to chronic disease before they require expensive late-stage interventions. Even when patients have chronic conditions, proper management and control ensure fewer costs than out-of-control diseases that have progressed too far.
While prevention is vital, there are many other ways a value-based care system can save you money:
- Data sharing: Open communication and cooperation streamline administrative processes and wasteful spending.
- Patient engagement: When patients have the information they need, they can better manage their health.
- Personalized treatment: Value-based care uses evidence-based decision-making to personalize a patient's care so they get only the services, tests and procedures they need.
- Informed referrals: With better care coordination, patients can utilize non-hospital settings, reducing emergency department visits and hospitalizations.
- Reduced redundancies: Better communication means fewer unnecessary or duplicative tests and procedures.
- Better prescription practices: When providers understand their patient's unique needs, they can prescribe generic medications when possible.
Value-Based Care vs. Fee-For-Service Models
The value-based care system marks a tangible shift away from reimbursement models that reward the volume of services provided. Fee-for-service (FFS) compensates healthcare entities based on the number of services delivered, regardless of quality. This means patients pay individually for office visits, tests and treatments, even if these services are related.
The danger of FFS is the incentivization of quantity over quality.
Value-based care has grown exponentially as an alternative or even replacement for FFS reimbursement. This model links payments directly to the quality of care delivered. Providers receive compensation for efficient and effective service — not just the volume of activity.
The Success of Value-Based Care
It's hard to argue the value of value-based care. The ability to reduce costs and provide better patient satisfaction is not just aspirational but achievable under this system.
However, the success of value-based care is more difficult to measure than a fee-for-service model. It can be harder to see results when focusing on prevention, such as avoiding new conditions and managing existing ones.
Here are some metrics that can help your center measure the success of a value-based care system:
- Overall patient satisfaction.
- Patient-reported outcomes.
- The rate of preventive care services.
- Chronic disease management and medication adherence.
- Care coordination and a cooperative care plan.
- Reduced hospital readmissions or ambulatory care-sensitive hospitalizations.
- Decreased use of emergency departments for non-emergency issues.
How Can Medrina Help Your Organization?
In 2018, the Centers for Medicare and Medicaid Services finalized the Patient-Driven Payment Model (PDPM). This value-based classification model ensures patients in skilled nursing facilities (SNFs) receive the right care at the right time, not just a volume of services.
While there are many advantages to PDPM, your center may be struggling to understand these benefits. Medrina can help. We connect you with highly skilled physiatrists who understand the complexities of the Patient-Driven Payment Model. They work with your center to enhance patient care and outcomes, increase collaboration among your team, and maximize the full potential of the PDPM system.
Optimize Your Reimbursements With Medrina
Let us help you successfully capture potential reimbursements available through PDPM. Contact Medrina today to learn more.