The Pros and Cons of Value-Based Care

Value-based healthcare is a pricing model that incentivizes your practice based on the quality of services you provide to patients. Within a value-based payment model, your practice is compensated depending on a patient’s health outcomes.
The goal of a value-based care system is four-fold:
1. Improve the quality of healthcare
2. Improve the patient experience
3. Lower costs for patients
4. Improve the care team’s experience
Healthcare providers need to produce data to demonstrate clinical outcomes that measure these four metrics in order to show improved health outcomes for patients. To do that, doctors must leverage modern data by using software to support decision-making when transitioning to a value-based care model.
Pros:
Patients get more bang for their buck: Patients spend less money for better healthcare because value-based care doesn’t incentivize practitioners to throw solutions at the wall to see if they stick. That means providers won’t benefit from recommending services their patients may not need or treatments that may not work, which will save patients money.
Patient experience and engagement are prioritized: Providers are equipped to offer a better patient experience because a value-based model requires them to be more efficient and strategic with the care delivery they offer during each patient visit. It rewards you for delving deeper into the underlying problems your patients is experiencing instead of just running several tests, which can be costly, stressful, and uncomfortable for patients.
The doctor-patient experience is less transactional and more personal: During initial consultations, doctors and nurses spend time with their patients to get a more holistic idea about the reason for their visit. This improves the healthcare experience for patients, as their needs are personally attended to.
Cons:
More regulations and tracking occur: Although value-based healthcare is typically more beneficial for patients, it can be a hassle for practices because of the increased regulations placed on a healthcare provider. Because the government sets the terms of value-based care, it restricts how much you and your practice can do.
It’s hard to make the shift to value-based care: Because fee for service is so entrenched in the healthcare industry, it can be a tough sell for an entire healthcare organization to make the shift because of the uncertainty that comes with it.
Tracking metrics is more complicated and subjective: Because billing is tied directly to the quality of patient care delivery, a provider needs to invest heavily in resources and software tools that are necessary to track important health metrics such as hospital readmissions, adverse events, population health, and patient engagement during treatment.
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