Perceptions towards healthcare have shifted with time. It is not about merely the quantity of services provided anymore; it is about caring for multiple disparate factors as well. It has given rise to value-based healthcare.
What is value-based healthcare? Basically, it is the value that a healthcare provider provides to the patient over the volume of services that it renders.
To understand it more comprehensively, take a fee-for-service model.
In this model, hospitals earn based on the quantity of services they deliver. Outcomes such as how the patient felt, whether they were healed, and whether they were properly cared for aren’t considered.
With a value-based system, however, the goal is to achieve better patient outcomes and overall patient health. It emphasizes factors other than service quantity, such as efficiency, cost-effectiveness, and quality.
Let us look into the principles that define value-based care and how they can be implemented.
What are the Key Principles of Value-Based Health Care?
There are multiple principles of value-based healthcare. However, the key ones among them include:
Patient-Centered
Value-based healthcare is patient-centric. It focuses on providing the patient with maximum satisfaction, engagement, and personal care.
Value is provided to the patient by meeting their unique needs, which requires involving the patient in planning. If the patient is incapable, their guardian is included in the decision-making process.
Quality Improvement
Value-based care doesn’t still have a single quality of patient care. Constant improvement is necessary. This improvement comes from two factors.
One is patient feedback, and the other consists of an evidence-based approach that focuses on reducing medical errors and enhancing the effectiveness and safety of delivering healthcare.
Outcome Measurement
Measuring the outcome is central to providing quality and value-based healthcare. What is the outcome of the care that the patient gets? Is the patient feeling healthy now once the healthcare is provided?
An outcome is measured based on the patient’s medical state after receiving the care and the number of times they were readmitted.
Care Coordination
Coordinated care means the coordination between healthcare providers as they are treating a patient. It is the most important parameter to measure the value of a healthcare provider for patients who suffer from multiple maladies.
Here, the goal is to ensure that the patient doesn’t undergo unnecessary tests or bear unnecessary costs.
Population Health Management
Value-based healthcare is not about only a single patient. It is about the health of the entire community. Another key metric to see whether a healthcare provider delivers value-based care is whether it takes a proactive approach to improving the health of the communities.
It also considers the measures a healthcare provider has taken to prevent illnesses in a region. One of the leading examples of this is the COVID-19 pandemic.
Affordable Healthcare
Cost concerns stop many from receiving quality healthcare. How a healthcare provider manages the cost of its medical services is, therefore, one of the key factors to consider when assessing whether it offers value-based care.
A healthcare provider’s goal must be to contain the costs, which means not engaging in unnecessary services and tests that the patient doesn’t require.
Altering the Payment System
As we mentioned at the start of this guide, Value-based healthcare organizations do away with a fee-for-service model and instead opt for a pay-for-performance model. For these healthcare organizations, financial incentives only arrive if the patient is satisfied.
HIT Integration
Healthcare Information Technology (HIT) is an application that records a patient’s health and offers data analysis services. Prominent healthcare organizations that seek to provide quality healthcare to their patients have these facilities installed to provide deeply personalized healthcare.
With HIT integration, hospitals can engage with care coordination, and population health management and make data-driven decisions.
How to Implement Value-Based Health Care in Healthcare Organizations
The National Library of Medicine has outlined a good framework for implementing value-based healthcare facilities. This framework takes into consideration one thing: value-based healthcare is not a Utopian concept. It can be reached easily using a specific system.
This system consists of five stages:
Understanding the Shared Health Needs of Patients
The healthcare system is created around categorizing specific service providers. For instance, ophthalmologists work together, and cardiologists and endocrinologists do too.
However, this separation can create issues for patients with multiple maladies. Therefore, health care should be organized into different kinds of segments, such as categorizing patients that have the same needs. Basically, a broader category has to be created so that specific issues can be addressed. For instance, diabetic patients with leg issues can receive shared care if they are categorized under “people with knee pain”. This approach is only possible through inter-department communication.
Designing Solutions to Improve Health Outcomes
Once the common needs of the patients are identified, teams from different departments can come together to create holistic solutions. The goal changes from merely treating patients to solving their issues.
The coordination can be between two different medical teams, such as internal medicine and physical therapy, for patients who have diabetes and leg pain. Or, a coordinated care facility can involve a clinical and non-clinical team, such as a cancer patient requiring the aid of a transportation team’s assistance to get treatments.
Integrating Learning Teams
Integrating the learning teams involves putting together a team with members from various disciplines. This team can work in tandem to care for a patient. Often, these teams are located in the same palace, which doesn’t create communication issues. However, when the team’s structure is expanded in multiple locations, careful coordination among them is necessary.
Measure Health Outcomes and Cost
The fourth phase measures the health outcomes. The process is not complex. To do so, healthcare facilities need to define healthcare for a patient first.
Then, they can focus their attention on measuring how much the patient has improved.
Once the healthcare outcome has been measured, the focus goes to using cost-grouping methodologies that entail testing costs and other patient care facilities.
Expanding Partnerships
The final phase of this equation is expanding partnerships between different departments and healthcare organizations. It creates an integrated team-based environment that helps with proper patient care. These partnerships can be enhanced further by reaching rural clinics as well.
Conclusion
The spirit of value-based health care is to provide value to that patient. The principles of this unique approach involve focusing on the outcome of the facilities rather than the facilities themselves.
Implementing it requires that healthcare organizations understand the unique needs of a patient and act accordingly, for that’s the only way to ensure better healthcare for all.
