Understanding the Key Principles of Value-Based Healthcare
Improving value in healthcare is now a widely-accepted goal among patients, physicians and health plans. However, value transformation requires a complete shift in culture and practice.
It means moving away from siloed organizational structures by specialty departments and discrete services to a single medical condition-focused facility called an integrated practice unit (IPU). It also involves using the US home care software that makes accessing, analyzing, and reporting outcomes and costs data easier.
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Providing patient-centered care is an integral part of implementing value based healthcare. Patients are expected to become active participants in their care and to be fully involved in making decisions about their health. This requires collaboration between patients and their clinicians and support staff, which includes family members. In addition, it means accommodating patient concerns, such as fears about their clinical status or financial burdens.
Ultimately, patients are rewarded with better outcomes and quality of care when the emphasis is on patient-centered care. This translates into fewer medical errors and less expensive medications, procedures and tests. In the long run, it also leads to healthier populations.
As such, value-based care is a great way to improve the overall quality of healthcare in America and other countries worldwide. It provides patients a better experience while lowering costs, reducing medical errors, increasing positive patient outcomes and satisfaction, and encouraging healthy lifestyles.
The physician-patient relationship is an integral part of the healthcare system. Physicians need to be able to communicate effectively with patients so they can understand medical concerns and make appropriate decisions together. This is especially important when addressing death and dying but applies to more routine matters.
Value-based care models promote strong patient-clinician relationships while delivering high-quality, cost-effective health care. They help providers achieve the aspirational goals of the Institute for Healthcare Improvement’s triple aim – improving outcomes, reducing costs and increasing clinician satisfaction.
However, not all patient-centered models are created equal. Some have been described as paternalistic, where physicians make decisions on behalf of their patients without explicit consent. This is often done for patient safety or to avoid violating patient confidentiality rules.
One example of a physician group that uses value-based care principles to improve patient-centeredness is the University of Texas at Austin’s Dell Medical School (DMS). It incorporates education about these concepts throughout the four years of undergraduate medical school and offers clinics organized around segments of patients with shared needs. Interdisciplinary, outcomes-focused teams manage these clinics.
Another approach to promoting the patient-centered values of value-based care is providing financial incentives to providers to participate in these programs. These can take the form of sharing savings or sharing risk with payers. The latter involves a set budget for the costs of care being provided to patients, and providers that spend less than the budget would share in the savings.
Shared decision-making is a key part of value-based healthcare. The goal is to ensure patients have access to the information they need about their health condition, treatment options and potential risks and benefits while also considering their goals, values and preferences. This is an integral part of a patient-centered approach to care, and it helps to improve service outcomes and reduce redundant costs.
Patients engaged in shared decision-making with their clinicians tend to participate more actively in their health and wellness journey. They are more likely to follow their doctor’s advice and adhere to their treatments, which helps them achieve better outcomes. But the reality is that sharing decision-making in clinical practice can be challenging.
A lack of knowledge and the burden of navigating complex medical information are barriers that must be addressed to make this happen. Educating patients is critical, and interactive tools like decision support systems can play an important role. But more than just handing patients a stack of leaflets and websites are needed to ensure they understand their options and how their choices might affect them.
Another area for improvement is that many value-based care groups focus on cost, which can conflict with the patient’s desire for the best and most modern treatment. And as many of these groups have narrow networks, they may need help to provide their patients with all the latest medications and advanced diagnostics that can improve outcomes.
Patient accountability is integral to value-based healthcare, encouraging patients to participate in medical care. This includes adhering to preoperative preparation instructions and ensuring that they are making healthy lifestyle choices. It also involves taking responsibility for their health, including avoiding tobacco and other unhealthy substances.
In addition, value-based care models focus on improving outcomes rather than merely treating symptoms, which helps reduce costs. For example, reducing the number of people with chronic conditions lowers hospital admissions and associated expenses. This allows the healthcare system to shift resources away from addressing medical emergencies and towards long-term management of diseases such as diabetes.
However, it can be challenging for physicians to balance the demands of value-based healthcare with their daily practice. For instance, a physician may have to deny a specialist referral or the latest drug to optimize patient outcomes and meet quarterly revenue goals. Moreover, it can be difficult for patients to understand their financial obligations under a value-based healthcare model and determine whether they are treated fairly.
Value-based care can effectively improve healthcare quality and reduce costs, but it requires a significant commitment by all parties involved. Fortunately, many resources are available for healthcare providers who want to move in this direction.