The Future of Value-Based Care and Why is it So Vital?

When approaching care models, experts agree that value-based care contributes to more robust cost controls and better patient outcomes. The future of healthcare is trending towards a value-based healthcare model, and this change is vital to the entire healthcare landscape. 

According to the New England Journal of Medicine, value-based healthcare is “a healthcare delivery model in which providers, including hospitals and physicians, are paid based on patient health outcomes.” Providers are compensated not based on how many procedures they perform, or how many patients they can see, but by the tangible health outcomes of their patients. 

The currently favored fee-for-service healthcare model is slowly being phased out and losing popularity with healthcare organizations. In 2015, the US Department of Health and Human Services set a lofty goal of having 50% of Medicare reimbursement tied to value-based care by 2018. The most recent data shows that the goal fell short, reaching only 36% reimbursement by the end of 2018. However, physicians and health experts continue to drive the healthcare industry towards a value-based model. 

The Future 

Value-based healthcare is an anomaly in this day and age because it enjoys overall bipartisan support in government. The model also has wide-reaching support from patients who seek improved outcomes, a more community approach to their health and wellness, and a better, more holistic relationship with their physicians. 

Providers who see the writing on the wall regarding value-based care may have been preparing their practices for years, investing financially and in areas of logistics, personnel, and procedures to meet the growing demand. The future of value-based care will require buy-in from providers in developing dedicated care teams, staffing levels prepared to offer a “whole person” approach to care, and adaptation to technology and data tools designed to make value-based care models more effective. 

As of 2020, 54% of nationwide physicians were connected to at least one value-based accountable organization. While this number is promising, many physicians still have their organizations tied to fee-for-service-based processes. As value-based healthcare becomes more the norm — rather than the exception — in care, the proverbial band-aid may need to be ripped off, and more providers will need to refine their processes and change course.

Why is Value-Based Care so Vital? 

Value-based care is looked at so favorably due to its cost-effectiveness and the stark rise in favorable patient health outcomes. In addition, there is a proven higher level of patient satisfaction and efficiency within a value-based model. 

The current healthcare landscape could easily be seen as problematic in the United States. Currently, the United States has a lower life expectancy than their peer countries. The disease and disability burden in the United States is also far higher than in other industrialized countries. In terms of healthcare access and quality, the US falls lower than other countries such as Germany, France, and the United Kingdom. The US also falls below the comparable country average with this metric. 

These sobering numbers point to a need for swift change within the healthcare landscape that many believe value-based healthcare could bring. Value-based healthcare requires more cooperation between the payer, insurance companies, and the provider. There exists a broader sharing of data and expectations, which leads to better transparency throughout each patient’s individual healthcare journey. 

The transition to value-based care nationwide is already underway. Many companies exist that offer technological and data-based advancements designed to help providers seamlessly transition from fee-based to value-based models. Providers, payers, and patients are all largely on board with the idea of value-based healthcare. With time, attention to seamless transfer, and education, the value-based model may be poised to change the future of healthcare radically.