Value-Based Care Gains Favor as a Provider Reimbursement System

Health care experts believe value-based care could lower costs and improve patient outcomes. The United States spends much more on health care per capita than other wealthy countries — $10,384 versus an average of $5,169, show studies such as the Peterson- Kaiser Health System Tracker. Despite the high spending levels, though, health outcomes in the U.S. are worse than in other wealthy countries. What can be done to lower America’s high rates of medical error, disease and death?

Many health care experts believe value based care is the answer — and that it can provide better and more affordable care. Other experts have concerns that this alternative to traditional care could be difficult to implement and may be unsustainable. Value-based care pays health providers based on how much they improve a patient’s quality of health management. Quality of care is based on metrics including reducing hospital re-admissions; improving preventative care; and using health technology. Value-based models reward providers financially when they deliver better and more cost-effective services and often penalize them financially when they fail.

In comparison, traditional care — also referred to as fee-for-service-care — reimburses providers on the amount of services they provide. For instance, the more tests and procedures a provider orders, the more money they earn. The emphasis appears to be about quantity of care. Supporters of the value-based model claim this approach offer better outcomes for patients because it focuses on quality preventative care, rather than expensive and sometimes unnecessary tests. Another reason for the growth and interest in value-based care is the growth of technology in the health field. Digital health solutions such as tele*health and artificial intelligence wearables assist in monitoring outcomes.

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