Healthcare providers and payers are under lots of pressure to improve patient outcomes while reducing costs. The solution lies in a transition to value-based healthcare.
Value-based healthcare is a type of reimbursement that rewards healthcare providers with incentives based on the quality of care they provide to patients.
This model revolves around the patient’s treatment and how well healthcare providers can improve their quality of care based on certain metrics, such as improving preventative care and reducing hospital readmissions.
Simply put, healthcare providers are now expected to: Do what is right for the patient. Do what is best for the patient. Do it at the times that are best for the patient and do it as cheaply as possible. Provide the best health care that you can for the patient. That is value-based medicine.
There are several factors behind the shift to value-based medicine.
- Each day, about 10,000 Americans turn 65, and by 2030, all baby boomers will be at least age 65, according to the Census Bureau.
- An increase in chronic diseases and conditions around the world requires better delivery of healthcare.
- Patients want to be more involved in managing their healthcare. Healthcare specialists must take time to listen to their patients and respond to them with all the information available.
Traditionally, healthcare operated on a fee-for-service healthcare model. This system incentivized healthcare providers to order batteries of tests and procedures and increase their total number of patients in order to bring in more money. A patient is charged for every visit, test, medication, and treatment. It is a reactive system, centered on illness rather than wellness. Little attention is paid to outcome measures. Payment is made regardless of how the patient perceives or experiences the outcome. Fee-for-service based care emphasized quantity, value-based care emphasizes quality.
Under the value-based care payment model. the Centers for Medicare & Medicare Services (CMS)can reward providers who require less money and get better outcomes and, alternately, punish those who don’t.
Value-based healthcare can increase the overall wellness of patients while saving money.
- It decreases the cost of services — possibly by changing the approach to offering those services — while still providing the same outcome.
- It increases the outcome of well-being without increasing the cost of care.
Medical teams who regularly monitor their patients and know their health histories are better able to help counsel patients on how to make positive changes in their lives to increase health or better deal with existing health issues or illnesses.
The U.S. healthcare industry continues to inch toward value-based healthcare and away from fee-for-service. Over the past eight years, the number of states that implement value-based healthcare programs has spiked — rising from three states to 48. When it comes to reimbursement models, the HealthCare Transformation Task Force reports more than 75 percent are projected to be on board by the end of 2020.
Value-based care is very much at the core of what urgent care offers patients. Urgent care can go beyond what a typical primary care physician or emergency room can provide patients. Not only are costs lower for patients who use urgent care rather than an ER or PCP, but the accessibility and convenience of care are also beyond compare. Urgent care centers have moved beyond just treating emergencies, to being considered an alternative to primary care.
American Family Care, the nation’s leading franchised provider of urgent care, accessible primary care, and occupational medicine, was an early adopter of value-based healthcare — opening and operating its first clinics in 1982 with the concept of convenient, patient-centric healthcare.
If you want to partner with a visionary leader in the healthcare industry, click here to learn more about franchising opportunities with American Family Care.
