Value Based Care

Value Based Care - What does that even mean?

At its basic core, Value Based Care (VBC) ties payment for services to the outcomes of clinical care. The better the care, the better the reward. The idea is to reward providers for efficiency and effectiveness in patient care. Essentially, VBC is positioned to disrupt the traditional fee-for-service model of healthcare and reinstate to quality healthcare. Sounds perfect right?

Well, VBC has faced many challenges in being fully implemented at scale. Some of the areas of concern are:

• In 2019, only 38% of healthcare spend went through a value based payment model.

• Experts are worried a VBC payment model could be detrimental to Medicare Advantage beneficiaries with chronic conditions - incurring significantly more costs.

• Current Centers for Medicare & Medicaid Services (CMS) regulations act as a red tape to VBC adoption

These challenges (and others) have made some industry leaders skeptical of whether existing healthcare incentives will support a value based care model alternative.

If VBC is to succeed, one thing is clear - access to data is the key to ensuring the right insights are given to providers at the right time to improve outcomes and prevent disease. Data exchange that enhances care coordination and communication between payers and providers is what’s needed the most.

Digital health companies will play an integral role in interoperability and data access that supports VBC. In fact, VC dollars have already started to support VBC models through several investments in digital health companies focused on home and community services, reproductive care and primary care.

We’ll continue look to see which digital health startups solve for the infrastructural needs of the VBC model and who is betting big early on this next phase of healthcare.

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IN THE NEWS

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Healthcare Big Data and the Promise of Value Based Care

NEJM Catalyst

Efficient Data Sharing Needed for Value-Based Care Transition

Rev Cycle Intelligence

How Payers Can Move Providers Along Value-Based Care Continuum

Kelsey Waddill

Providers transitioning to value-based care contracts may find the need to ease into the most advanced value-based care models. As a result of this transition, a wide range of VBC agreements exist. The ultimate goal among payers, is to move their provider partners into contracts in which providers receive incentives for high-quality care and penalties for low-quality care.

7 ways to cut value-based care's regulatory red tape

Fierce Healthcare

How physicians can untangle the web of relationships essential for value-based care success

Medical Economics

Why Value Based Health Care Can Be Costly for People in Medicare

Next Avenue