Let’s go back couple of decades. Remember going to a physician and he would ask you to get X-ray, blood test and 10 other tests just for sprain? More often than not, patients would face something similar and if you hadn’t, then, trust me you were among the lucky ones. The rationale behind this could be somewhere around providing more and more services. Not surprisingly, sometimes even when they weren’t needed! ‘Fee-for-service’ model. The name says it all. A model where providers received payment for the services provided. The major flaw, as one would guess, was that the focus was on quantity of care, but not on the quality of care.
Why Value-Based Care?
When healthcare spending is over $10,000 per person, one would expect better outcomes! Like higher life expectancy or low birth mortality rate! None of that happened, but the variations in the cost of care went too high to ignore. The variation in the expenses was on an average almost 3 times the actual cost.
These variations persisted even after accounting for the social determinants and other factors. Greater expenditure did not reciprocate to better health outcomes. The recent data suggests, it probably won’t! As high as $3 trillion are being spent by the US Government on Health Care and still US has a higher infant mortality rate than other OECD nations!
What is Value-Based care for Patients and Providers?
Patients are the ones who get the best out of Value-Based Care. For a patient, it could mean easy access to affordable and effective care. For providers, it means utilizing past experiences to improve the quality of care. This will help in implementing next generation solutions and realizing dollars. But there is a lot more than just past experiences to Value-based care. Risk identification, timely intervention, reduction of readmission rates and many others. When there is a considerable improvement in the Population Health only then it could be said that true Value-Based Care is in place.
What’s holding Value-Based Care back?
If Value-Based Care is this good in reducing cost and making healthcare effective, then why haven’t can’t we completely implement it? What is the one missing piece of the puzzle, which is blocking the implementation of Value-Based Care? It isn’t just a piece, but pieces of the puzzle. Here are the challenges faced while implementing Value-Based Care.
Big Data. Big Solutions.
Value-Based Care is all about being ahead of the curve. That’s it! Imagine having a revolutionary product, which can not only sort out your claims data, but also performs analytics on it, providing meaningful insights. A product which keeps your health coaches in the loop, identifies risk and helps in planning timely interventions. The possibilities are innumerable! Just think about all the things that could be done once you’ve a next generation tool that performs aforementioned and a lot more.
Many say Value-Based Care is a curve ball. I disagree! I believe it’s definitely a Home Run!
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