What is Value-Based Medicine?

Value-based medicine is a system in which medical providers get paid based on patient outcomes. Essentially, the healthier patients are when they leave the hospital or doctor’s office, the more compensation those providers may get. The value-based medicine model provides an incentive for doctors to focus on the quality of care over the number of patient visits, which ultimately benefits the patients and even society as a whole. If you’re not sure how the value-based healthcare model works or what its advantages are, here’s what you should know about it.

How Does Value-Based Medicine Work?

The point of this healthcare delivery framework is to reward providers for patient outcomes that are better than average. The more traditional alternative to the value-based healthcare model is the fee-for-service framework, in which medical offices are paid for the number of healthcare services they provide, such as several appointments and treatments for one patient. This somewhat incentivizes poor quality of care because the more visits and procedures a patient has, the more revenue a provider receives.

By contrast, value-based healthcare companies focus on helping patients improve their own health. For example, a patient who goes to a doctor with health concerns due to being overweight and smoking regularly will get a diagnosis and treatment plan for any chronic or acute health issues. But he or she will also get help making lifestyle changes that can improve his or her health, such as a referral to a dietician for weight loss and information on a program to help the patient stop smoking. Getting the patient engaged in improving all aspects of health—with the guidance of medical professionals—can lead to better outcomes, which is the goal of value-based medicine.

What Are the Top Value-Based Medicine Benefits?

Value-based healthcare has advantages for everyone, from patients and providers to society in general. After all, the whole idea of this healthcare delivery system is to provide better health outcomes in less time and fewer doctor appointments than usual. So it should come as no surprise that this framework is beneficial for most people and to the cost of healthcare.

To start, value-based healthcare typically allows patients to save money on their healthcare costs. This is because instead of simply going to a doctor only when an acute health problem comes up—often leading to hospitalization, surgery and/or medication to treat it—they’re working with a qualified team to improve their lifestyle. When part of the healthcare they get includes preventative care, nutrition advice to help with weight loss, and therapy to improve mental health, they’re less likely to end up in the hospital with serious conditions.

Value-based medicine can also benefit providers. When they require fewer appointments to treat people, they can take on more patients. And when the patients they already have are seeing better health outcomes in fewer doctor's appointments, they’re likely to feel satisfied with their healthcare. This can lead to excellent reviews that will attract more patients to the practice, which is how the value-based healthcare model can improve efficiency and profitability for providers.

This framework can assist society mainly because when people are healthier, everyone benefits. When patients are equipped with the knowledge and support to prevent and manage chronic conditions at home—such as by eating healthier, exercising regularly, and monitoring their blood pressure—they spend less time and money at the doctor. This allows them to save money while allowing doctors to take on more patients, so everyone gets the healthcare they need.

Not only does this let patients save money on healthcare, but it also leads to cost savings for providers and healthcare expenditure as a whole. After all, one report found that 12 percent of US citizens have five or more chronic health conditions, which accounts for 41 percent of healthcare expenses in this country. And 90 percent of the money spent on healthcare in the US goes for treating those with chronic or mental conditions. The fact that value-based medicine is especially helpful in treating chronic conditions means this framework can make healthcare much more cost effective.

How Is Value-Based Medicine Delivered?

Now you know the basics and the benefits of value-based medicine. But what are the methods and tools that providers can use to get started with this healthcare delivery model? First, you need to start by creating a network of providers who can work together to give patients comprehensive healthcare. This might include primary care doctors, therapists, nutritionists, post-acute care doctors, and specialists. The goal is to have a group of medical professionals who can collaborate as needed and refer patients to each other instead of working in a silo to offer medical care. Often times this is done through the use of Accountable Care Organizations (ACOs).

Once there’s a network of like-minded providers in place, it’s important to use tools that can accurately and instantly share health information for each patient seeking treatment. Therefore, electronic health records (EHR) are critical in value-based healthcare, as they make it possible for a group of medical professionals to coordinate their care for patients. With an EHR, all providers can check the system to view test results, past medical treatments, allergies, and general medical histories. This can reduce the chances of different providers performing the same treatment more than once. As a result, providers will find it easier to collaborate with each other to find a solution to their patients’ medical issues without being redundant with their care, which can reduce healthcare spending and result in better health outcomes overall.

Get Help Transitioning to Value-Based Medicine

If you’re interested in learning more about the value-based healthcare framework—and want to see how it would work for your practice—contact TempDev today for a consultation. Our approach to value-based medicine will help you shift seamlessly from fee-for-service to the fee-for-value model. Our experienced team and advanced tech-based tools can help your practice with everything from technical changes to workflow improvement as you adjust to the value-based healthcare model in your office. We look forward to discussing with you how our services can make a difference for your providers and patients alike!