The Advantages of Value-Based Care for Patients and Providers

Value-based care shifts the healthcare focus from quantity to quality, resulting in healthier patients and a lower cost of overall care. It reduces medical errors, fewer hospital visits, readmissions and medical emergencies.

It also helps practices collect valuable new insights. As a result, successful VBC programs often lead to measurable improvements in a practice’s operations.

Better Health Outcomes

The healthcare industry is shifting away from fee-for-service payments and toward value-based care. These programs are designed to decrease spending while enhancing patient outcomes. This model incentivizes physicians and hospitals to improve various aspects of healthcare, including quality, cost, and equity. They earn bonuses if they exceed certain goals, such as reducing medical errors or lowering hospital readmission rates. They may even share in the revenue savings they produce. Patients also benefit from this model, resulting in better preventive screenings and more effective management of chronic diseases. In addition, they’re more likely to follow their treatment plan and be engaged in their care when physicians focus on patient engagement. This approach also reduces the administrative burden on physicians, allowing them to spend more time with their patients and reducing stress levels, which can contribute to physician burnout. Moreover, the lower costs associated with value-based care can also be passed onto consumers through reduced premiums or out-of-pocket expenses. These savings can be further increased by focusing on high-value drugs rather than lower-cost generics.

Lower Costs

In a value-based care environment, patients can expect to spend less money. The shift from volume to value encourages a team-based approach that reduces the amount of unnecessary testing and procedures. Patients are better educated and incentivized to play a dynamic role in their healthcare with tools like telemedicine, online patient portals, and access to their health data. Providers can also benefit from value-based care. According to experts like Foresee Medical, value-based programs incentivize providers to manage patients more effectively through wellness, prevention, and controlling chronic diseases. As a result, they’ll need to perform fewer tests and medical procedures and prescribe cheaper medication. Providers can also opt into risk-sharing payment models, like bundled payments, accountable care organizations, and patient-centered medical homes, which require them to assume some cost risk and share savings with payers. This means that they must continuously improve the quality of their services, upgrade their IT infrastructure, engage patients, and use data analytics to prove that they are adding value.

Better Patient Experience

With value-based care, physicians and healthcare professionals focus on the best outcomes for each patient. They may reduce unnecessary tests and procedures, and patients receive better treatment through a more integrated healthcare system that includes electronic medical records, care coordination, and teamwork. This can also result in fewer hospitalizations and emergency room trips, saving a lot of money for insurers and patients.

Another advantage of value-based care is the emphasis on wellness and prevention, which can help prevent future health crises.  Healthcare providers can prepare for a transition to value-based care by implementing the right technologies and systems. Region’s hierarchical visualization, rules engine and healthcare industry IP can help payors and providers organize provider network data and develop automated care coordination workflows triggered by specific conditions or events. 

Better Patient Engagement

Healthcare providers in value-based care arrangements are often incentivized or rewarded for meeting certain goals that align with the quality and patient engagement measures that payers like Medicare, Medicaid, and commercial health insurers use to evaluate their performance. Providers who successfully deliver high-quality and cost-efficient care will see their reimbursement rates increase compared to traditional fee-for-service models.

A primary goal of value-based care is to help society become healthier while reducing overall healthcare spending, which accounts for almost 18% of the country’s GDP. One way to achieve this is by promoting healthy habits and self-management of chronic diseases through better education while cutting back on unnecessary hospitalizations and medical emergencies.

To do this, patients and clinicians must collaborate to develop a personalized treatment approach and achieve the best outcomes. This can be accomplished through shared decision-making programs, which allow physicians and patients to work together in selecting tests and treatments based on clinical evidence. This results in higher levels of patient engagement, which reduces no-shows and drops outs and increases patient retention and satisfaction.

Better Patient Relationships

Value-based care aligns various parties with shared goals—patients, healthcare providers, health plans/insurance providers, employers and other payers, and suppliers. As a result, patients are healthier, costs are lower, and everyone is happier. The shift to value-based care has some downsides, however. For example, many “value-based” groups are responsible for a patient’s healthcare cost. This approach can sometimes limit their ability to contract with the marketplace’s most reputable hospitals and specialists. Sometimes, this can result in long wait times for specialty care—a major annoyance for patients who expect access to the best options.

In addition, the new focus on quality over quantity can create frustrations for some physicians, resulting in a heavier administrative workload. This can lead to burnout, reduced job satisfaction, and even turnover for some physicians. However, if physicians can spend more time with each patient and address non-medical aspects of wellness—encouraging healthy habits or social support networks—this can improve the overall experience. It also can help reduce medical errors, contributing to higher costs and poor patient outcomes.


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