The rising cost of healthcare is a top concern for most Americans, and that includes healthcare providers as well as patients. In the last several years, there has been a shift from the traditional fee-for-service (FFS) model to value-based or pay-for-performance in some areas.
In the FFS model, physicians and other providers are paid based on how many services they deliver. Compensation is based on quality rather than quality.
Value-based care takes the opposite approach. Healthcare providers are paid based on the quality of care and patient outcomes in a value-based model. Many healthcare systems are switching to a value-based healthcare model because they find that both patients and providers benefit in several ways.
Patients Spend Less for Better Outcomes
Because value is at the heart of this system, patients will pay less to get the right care. In value-based healthcare systems, care providers focus on preventative care that is less costly than treating a chronic condition like diabetes, hypertension, or obesity. Also, physicians and other providers focus on treatment methods that help patients recover from illnesses and injuries most efficiently. A patient in a value-based healthcare model will have fewer doctor’s visits, medical tests, and medical procedures. Additionally, they spend less on medication as their health improves.
Patient Satisfaction Increases in the Value-Based Model
In a value-based care model, patients are the focus of the healthcare process. They receive coordinated care from all of their providers, which is discussed later on. Unlike the fee-for-service model, doctors focus only on the tests and treatments that are best for the patient rather than doing as much as possible to collect more money. Not only does that save money, but the time spent during the exam or follow-up visit is more productive and engaging. Patients feel more like they are a part of the team rather than an item on a list to be checked off.
It is Efficient for Healthcare Providers
In a value-based care system, data from the care provider’s organization is collected and analyzed. Data analysis helps organizations identify health risks specific to a provider or system. The organization can then take steps to provide preventative care for those risks and make treatment more efficient. At first, implementing changes to improve preventative care is a time investment for some providers, but the benefits on the other end far outweigh that cost when they spend less time treating and managing chronic conditions.
There is more Coordination for Collaborative Care
In a traditional care model, healthcare providers don’t always have the ability or incentive to work with other providers to provide effective care for their patients. In a value-based healthcare system, there are incentives and improved technologies that enable providers to coordinate care. The integration produced by collaborative care creates better outcomes for patients because all of their healthcare providers work together to improve overall health.
General Health Becomes Better
The long term goal of value-based healthcare is making society as a whole healthier. The focus on preventing illnesses and providing efficient treatments translates to a population with fewer chronic conditions. The healthier a population is, and the less money all parties spend on healthcare, the better.
Overall Healthcare Spending Is Reduced
According to the Centers for Medicare & Medicaid Services National Health Expenditure Data, 17.7% of the United States’ gross domestic product (GDP) was spent on healthcare in 2018 (GDP measures the total value of goods produced and services provided by a country in a year). When fewer people need costly care, total healthcare spending decreases, which has beneficial financial implications for individuals, businesses, and the government.
Costs Even Go Down for Insurance Companies
In a value-based system, patients, healthcare providers, and insurance companies all benefit. Value-based care lowers costs across the board, meaning that insurance companies have to pay out less money for the services their subscribers use. Why does this matter to you as a patient? When insurance companies have lower costs, they are less likely to raise premiums and deductibles.
The surgeons and associates at South Shore Orthopedics are committed to helping our patients get the best possible outcomes from their healthcare. That’s why our process has started promoting a value-based care model. We want patients to get the care they need without financial burden. If you have questions about how we use value-based care, or if you have an orthopedic health concern, call our office at (781) 337-5555 to make an appointment.