Since 2010, federal policymakers have invested billions in testing VBC models that aspire to increase quality and decrease healthcare costs.
But while many VBC programs have reduced costs, their impact on clinician and patient outcomes still needs to be determined. To drive success, future models should consider the timing, size, and delivery of incentives to providers.
Invest in Technology
Value-based care models shift the focus from consuming healthcare services to delivering better health outcomes. These models require providers to improve population health management strategies, enhance the quality of patient care, and reduce costs. However, implementing these models may be complex for many medical practices.
To maximize the benefits of value-based care (VBC), healthcare systems must invest in various capabilities. Including clinical workflow automation, EHR/analytics, and interoperability. As a result, healthcare organizations are increasingly deploying inorganic growth strategies through partnerships to acquire these capabilities rapidly.
For example, a large managed care payer acquired primary care provider networks to expand Medicare Advantage plans in key markets. And a community health network invested in an AI-powered virtual triage system to support members and drive operational efficiency. Additionally, many physicians are experiencing burnout and staffing shortages that hinder their ability to participate in VBC programs. But they also need to meet requirements for value-based care programs.
Despite these barriers, stakeholder interest in value-based care continues to grow. A recent study published in the journal Health Affairs found that physicians have an overall positive view of the impact of VBC on the quality of care and patient satisfaction. Moreover, while VBC participants’ performance in 2021 varied – 15 of the 53 entities participating in healthcare services direct contracting program lost money – Bain research suggests that physician interest in VBC will continue to rise as the industry learns from the early adopters and further regulation drives momentum.
Create an Integrated Care Team
Integrated care teams create an environment that encourages collaboration and provides more excellent continuity of care for patients. They allow physicians and other clinicians to focus on the holistic needs of their patients rather than being tasked with treating individual episodes of care. This approach can also lower costs by avoiding unnecessary services and improving the efficiency of the entire healthcare system.
To be successful, integrated teams need to have clear lines of communication between disciplines. This requires a collaborative culture where team members share information and best practices. Additionally, they must have a shared vision and goals to provide quality, integrated care for each patient.
The most critical factor in the success of an integrated care program is a deep commitment by participants to the new model. It must be understood that integrating care takes time, effort, and financial responsibility for everyone involved in the process. Leaders in these programs must understand the value of integrated care and are committed to its implementation.
Integrated care teams include doctors, nurses, physical therapists, occupational therapists, psychologists, health coaches, social workers, and insurance navigators. These team members provide the medical and emotional support that patients need to make healthy lifestyle changes, stick with their care plans, and minimize their risk of recurrence of health problems.
Create a Patient-Centric Culture
Healthcare is transitioning significantly, and the move to value-based care (VBC) is crucial. The US spends far more on health care than other high-income countries but ranks lower in access, equity, and health outcomes. VBC aims to improve these metrics by focusing on products that matter most to patients.
To meet the needs of their patients, healthcare practices must develop a culture that prioritizes collaboration and engagement. This will require establishing solid relationships and a genuine connection with patients, providing them with the tools and resources to become active participants in their care. This includes implementing patient portals with appointment self-scheduling, two-way communication, and telehealth options. These features empower patients and help them feel more confident in their treatment.
Additionally, a patient-centric approach must be inclusive and sensitive to the unique needs of diverse populations. This is often referred to as cultural competence.
While both patient-centeredness and cultural competence address the issue of quality, they do so in different ways. Patient-centeredness emphasizes individualized care and restores the emphasis on personal relationships, while cultural competency focuses on ensuring that all patients receive adequate care by addressing inequities. Both approaches are essential in creating a culture prioritizing patient satisfaction and quality. This will ultimately lead to better patient outcomes, satisfaction, and physician insights.
Focus on the Continuum of Care
When value-based care is well implemented, physicians and their staff can focus more on patient outcomes rather than the volume of services provided. In this way, patients benefit from a better overall experience, which can help them to manage their health in the long term.
Additionally, many organizations offer a continuum of care to support patients as they move through the treatment process. This can involve everything from diagnosis to rehabilitative therapy. This is a good thing for patients as it allows them to be more comfortable with the different stages of treatment and makes it easier for them to get the care they need.
To achieve the best patient outcomes, medical providers must work together to address the entire spectrum of a patient’s healthcare needs. This means collaborating across the continuum of care to ensure that all clinicians are up-to-date with a patient’s medical history, including past procedures and failed treatments. It also requires creating a system that collects data from each point of contact, whether in the hospital, clinic, or home.
To do this, many value-based care programs incorporate education on providing comprehensive, outcome-focused patient management throughout a person’s lifetime. For example, Medical School integrates value-based care into its undergraduate medical curriculum, teaching students the importance of providing high-quality, safe, timely, effective, efficient, and equitable. In addition, many clinical teams include nurse practitioners, physician assistants, pharmacists, and community health workers, which has been shown to increase access to care, decrease misdiagnosis, and reduce waste.