Value-Based Care: Will It Work?

Value-based care is a healthcare model that focuses on the quality of healthcare rather than charging based on the number of patients seen. With the traditional fee-for-service model, physicians are reimbursed for the number of patients they see, regardless of the outcome of the patients’ treatment. Alternately, a value-based care system will reimburse healthcare providers based on the outcomes for patients.

This healthcare model helps to encourage practitioners to employ measures that will increase the odds of a favorable outcome for the patients they see, which, in turn, can positively impact their monetary compensation. Rather than getting paid solely based on the number of patients assisted, they will be compensated based on how well their patients do following the medical care they receive.

With value-based care, patients’ overall wellness plays a key role in reimbursement.

Pros and Cons of Value-Based Care

There are a few advantages to value-based care, but there are also some drawbacks to consider.

Pros:

Better health outcomes. Value-based care may have a monetary incentive at its base, but patients themselves can benefit from better health and medical outcomes from their treatment. If healthcare practitioners are encouraged to ensure a better outcome for their patients to increase their compensation, their patients will likely benefit at the same time.

Reduce costs. Not only is the goal of value-based care to improve patient outcomes, but it’s also designed to reduce the cost of services. The healthcare industry can analyze current treatment plans and look at where money is being spent in the industry. By doing so, healthcare providers can revamp their services to ensure optimal value is being provided.

Medical teams that regularly monitor patients can better understand how positive changes can be made to improve health and deal with existing medical issues in a more effective manner. In turn, this can cut costs of healthcare by ensuring that healthcare practitioners choose the most effective methods of treatment for their patients from the start, thus providing better care more quickly.

This can be accomplished in many ways, including by improving preventative care, cutting back on hospital readmissions, reducing unnecessary visits to the ER, cutting back on excessive medical testing, and standardizing medical processes.

Employers may also choose to offer their employees value-based care benefit programs to increase employee health and wellness. This can be a money-saver for employers by boosting productivity and decreasing worker absenteeism.

Cons:

Complex situations can complicate matters. A more complicated case can be a challenge, particularly when it comes to hospital and home health value-based purchasing. It may also put healthcare providers at risk for repercussions for caring for these cases.

Potential to mislead patients. A value-based approach could risk patients being directed to providers who may not necessarily provide more affordable medical services.

Health Sharing Ministries Can Also Play a Role in Reducing Healthcare Costs

While a value-based approach may have its benefits in terms of improving patient outcomes and saving on costs, Americans also have another option to save money on healthcare through health sharing ministries.

These health care sharing ministries have become increasingly popular in recent years. Today, there are over 2 million Americans enrolled in these programs. These members can save as much as 30% to 40% compared to the cost of traditional health insurance.

Not only are health sharing ministry members cutting costs on medical care, but they’re also benefiting from more flexibility in terms of the types of healthcare practitioners they wish to see. This is a much different approach to managing medical costs.

At UHSM, we offer a variety of programs for members with different pricing structures, so there’s a program that’s suitable for every budget. To find out more about UHSM health sharing programs and which one may be better suited for you and your family, get in touch with a representative today or click here to see how much you can save with a health share program.