Value Based Healthcare
Value-Based Healthcare
I.
The metamorphosis of health care is underway with the shift from a volume-driven, profit-oriented environment towards a holistic, value-based care approach. A recent study by Managed Care shows that “Three-fourths of providers currently participate in at least one value-based payment model, and more than 60 percent expect them to become the dominant payment model (pg. 1).” But what really is value-based health care, why do we need it, and why is it portrayed as the solution to a seemingly unsolvable issue? Around the world, health care in nearly all systems is struggling with rising costs, decreased benefits, and uneven quality across the board. Well-intentioned and well-educated clinicians despite their hard work, cannot turn the system around themselves. It is not the participants of the system, but rather the system itself that is the issue. Countless incremental “solutions” like enforcing practice guidelines or attacking fraud have proved ineffective and inefficient ways to implement the much needed change in the Health Care System.
Value-based health care is directly related to patient’s health outcomes per dollar spent. Professor Michael E. Porter from the Harvard Business School says “value is the only goal that can unite the interests of all system participants” (Porter,2013,p2) value for the patient is at the core of value-based health care. In other words, “achieving the best outcomes at the lowest cost” (Porter and Lee,2013). It is a management strategy that focuses on quality and aims to create a culture of health within the whole organization. This includes the extension of the health care system beyond treating the patient and towards keeping the patient healthy. This effort will increase the value that a patient will receive, having not only the solution to short-term problems but to long-term ones as well. Lastly, “VBHC involves collaboration among plan sponsors, participants and providers to pursue high-quality and
I.
The metamorphosis of health care is underway with the shift from a volume-driven, profit-oriented environment towards a holistic, value-based care approach. A recent study by Managed Care shows that “Three-fourths of providers currently participate in at least one value-based payment model, and more than 60 percent expect them to become the dominant payment model (pg. 1).” But what really is value-based health care, why do we need it, and why is it portrayed as the solution to a seemingly unsolvable issue? Around the world, health care in nearly all systems is struggling with rising costs, decreased benefits, and uneven quality across the board. Well-intentioned and well-educated clinicians despite their hard work, cannot turn the system around themselves. It is not the participants of the system, but rather the system itself that is the issue. Countless incremental “solutions” like enforcing practice guidelines or attacking fraud have proved ineffective and inefficient ways to implement the much needed change in the Health Care System.
Value-based health care is directly related to patient’s health outcomes per dollar spent. Professor Michael E. Porter from the Harvard Business School says “value is the only goal that can unite the interests of all system participants” (Porter,2013,p2) value for the patient is at the core of value-based health care. In other words, “achieving the best outcomes at the lowest cost” (Porter and Lee,2013). It is a management strategy that focuses on quality and aims to create a culture of health within the whole organization. This includes the extension of the health care system beyond treating the patient and towards keeping the patient healthy. This effort will increase the value that a patient will receive, having not only the solution to short-term problems but to long-term ones as well. Lastly, “VBHC involves collaboration among plan sponsors, participants and providers to pursue high-quality and
References: Nicoloff, Nicole. A Comprehensive Communication Plan to Streamline Care Coordination Improves Patient & Physician Satisfaction., BerylHealth. April 03, 2013 Porter, Michael. “Redefining Health Care: Creating Value-Based Competition on Results” Harvard Business School Press. 2010, 86-87. 2 Works Cited Dartmouth-Hitchcock. (2014). What is Value-Based Care? Retrieved September 25, 2014, from http://www.dartmouth-hitchcock.org/about_dh/what_is_value_based_care.html eSync: Technology for Synchronizing Health Care Management. (2014, October 2). Retrieved from UnitedHealth Group: http://www.unitedhealthgroup.com/Programs/eSync.aspx Healthcare Managers Expect ‘Value-Based’ Contracts To Hurt Profits; Providers Pessimistic: KPMG Survey . (2014, June 19). Retrieved from KPMG: http://www.kpmg.com/us/en/issuesandinsights/articlespublications/press-releases/pages/healthcare-managers-expect-value-based-contracts.aspx Nerney, C. (2014, September 17). Midwestern Providers, Payers Blaze Trail Toward Value-Based Care. Retrieved September 22, 2014, from Healthcare Finance News: http://www.healthcarefinancenews.com/news/midwestern-providers-payer-follow-path-toward-value-based-care Optum. (2013, August). Can Value-Based Reimbursement Models Transform Health Care? Eden Prarie, MN. Top Questions About ACOs & Accountable Care. (2011). Retrieved September 29, 2014, from Accountable Care Facts: http://www.accountablecarefacts.org/topten/what-is-the-difference-between-a-medical-home-and-an-aco-1 Why are Accountable Care Organizations Important to Achieve Improved Cost and Quality? (2011). Retrieved September 29, 2014, from Top Questions About ACOs & Accountable Care: http://www.accountablecarefacts.org/topten/why-is-health-care-delivery-reform-as-proposed-in-the-affordable-care-act-necessary-1