Value-Based Healthcare: the New Frontier for American Healthcare?
As conversations across the country continue to ramp up surrounding the state and efficacy of the U.S. healthcare system, a new model has begun presenting itself as a viable alternative to the traditional fee-for-service models: value-based healthcare. As a new model of healthcare that is based on the principle of providing patients with value rather than volume, value-based healthcare puts an emphasis on the patient rather than on profit. Under this model, providers are rewarded for delivering high-quality care that improves patient outcomes, while patients can obtain the efficient treatment they deserve at a lower cost than under conventional models. This has become a particularly intriguing development for domestic travel for treatment and medical tourism to the United States for us at MyMedChoices™, as attainable and accessible value-based healthcare could incentivize patients to select to receive care in the United States, rather than look abroad for additional savings.
Value-based healthcare has many benefits for both patients and providers, and is widely thought of as a more equitable model for all parties involved than the current system. Some of the key benefits include improved results, as the focallity on quality in value-based healthcare encourages providers to emphasize on obtaining the best outcomes possible for their patients. In that same vein, value-based healthcare helps to reduce costs by encouraging providers to deliver high-value care instead of high volumes of low-value care, which leads to savings for both patients and providers alike, and subsequently leads to improved efficiency by encouraging providers to deliver care in this more cost-effective manner.
One such value-based healthcare model making waves throughout value-based healthcare are patient-centered medical homes (PCMH), which integrate specialty, primary and acute care into a coordinated, team-oriented approach to treatment. Here, a patient’s primary physician helps direct all of the individual professionals involved in a patient’s routine care for a more comprehensive care plan. Rather than take place in a singular physical facility, the term PCMH refers to the collaborative nature of treatment, particularly as this value-based healthcare model relies extensively on the sharing of electronic medical records (EMRs) amongst all team members involved for increased communication and a more robust understanding of a patient’s specific needs. With this focus on data sharing, doctors are able to strategically pinpoint and target the next steps of care by using test results and other procedures performed by other members of a patient’s team, while patients themselves are able to cut down on their costs by receiving more efficient care.
Accountable care organizations, or ACOS, help provide value-based healthcare care to Americans covered by Medicare, as designed by the Centers for Medicare & Medicaid Services (CMS). This, much like PCMH, is a patient-oriented structure that relies on a team of coordinated medical professionals to ramp up accuracy and efficiency, with all team members sharing the same risks and rewards – both financial and patient healthwise – to continue driving down cost while maintaining quality of treatment. Rather be encouraged to continue ordering tests and other extraneous treatments to drive up pay like doctors in fee-for-service models, the utilization of ACOS’ patient-oriented approach has shown demonstrable “improvements in outcomes such as hospital readmissions, adverse events, patient engagement, and population health” according to the NEJM Catalyst.
In conclusion, value-based healthcare is a new model of healthcare that is based on the principle of providing patients with value rather than volume through team-oriented coordination, and focusing on patient’s results rather than profit. Utilizing value-based healthcare and its submodels, providers are rewarded for delivering high quality care that improves patient outcomes, leading to better care for patients and improved health outcomes at a reduced cost. With issues like a lack of transparent pricing, excessive costs and a lack of flexibility presently giving the current U.S. healthcare system a bad rap, embracing value-based care in the future could help make the United States a more enticing healthcare destination for both residents and foreigners alike.
By Mary Schreiber Swenson