As you may know, the value-based healthcare model centers around improving the quality of healthcare provided to patients and preventing health issues from arising in the first place.
With a focus on prevention, the need for things like medical tests, unnecessary procedures, and ineffective treatments becomes reduced.
The model works like this: healthcare providers, such as doctors and hospitals, are paid based on the outcomes of patients, rather than the old fee-for-service model that paid healthcare providers based on the number of services they provided.
Basically, with a value-based model, healthcare providers are rewarded for helping patients to become healthier.
Now, let’s examine the key components of a value-based healthcare model.
Organized Care Around Medical Conditions
A value based approach in healthcare means care delivery is organized around the medical conditions of patients.
In order to deliver more value, healthcare providers must focus on deepening their expertise and expanding the way they serve the complex requirements of each individual patient through a full cycle of care.
Measured Outcomes and Costs
Measuring the outcomes and costs for each patient is an essential component of a value-based healthcare model.
Standardized outcomes, which are reported by condition in a transparent manner, are important for both improving care and enabling patients to make more informed choices about things like where they receive care and who provides the care.
When outcomes are measured, the quality of care provided to patients can be accurately reported and the successes of healthcare providers can be monitored.
The Alignment of Reimbursement with Value
With a value-based healthcare model, healthcare providers are rewarded for delivering the best outcomes for patients at the lowest costs. Furthermore, those who fail to effectively improve patients’ health can be penalized.
It’s important that reimbursement is aligned with value. The best way of aligning healthcare providers’ incentives with value is to utilize episode-based or bundled payments for complete care cycles.
Healthcare providers can then deliver maximum value to their patients. A bundled reimbursement payment covers all of the treatments and interventions that are performed over a full cycle of care for acute and chronic medical conditions.
Regional Delivery
Regional delivery of healthcare, which is organized around best-matching a healthcare provider, treatment, and setting, is a key component of a value-based healthcare model. That means the right care is provided in the right location.
In order to integrate healthcare effectively, providers must redefine the extent of services at each healthcare facility and view the services as elements of the whole organization.
Information Technology Practices
Using the right information technology system is a crucial component of any value-based healthcare approach. Healthcare providers should leverage IT to help restructure care delivery and measure results.
Providers need to be able to utilize IT for their value-based care in order to:
- Establish common data and precise language definitions to enhance reporting capabilities and outcome measurement.
- Combine all types of data for each patient.
- Aggregate data that encompasses the full cycle of care for a given patient and/or medical condition.
- Adopt interoperability standards to enable more effective communication among different healthcare providers.
- Enable access and communication to all involved parties, including healthcare providers, healthcare employees, and patients.
- Collect structured data in patient records.
- Create standardized templates for medical conditions that will help to improve usability and highlight the information that is most important for managing specific conditions.
- Allow outcome measures, process measures, and activity-based costing measures to be easily extracted for each medical condition and patient.