Population insights and care management  › What is value-based care? 

What is value-based care?

Find out how new preventive care and data quality models are revolutionizing healthcare payment and delivery

New strategies for holistic patient care

Value-based care is the intersection of cost and quality. Value-based initiatives shift the care delivery focus from volume to value and redefine financial incentives toward reduced costs. In this model, physicians must think about the entire patient experience among all care settings and between episodic visits.

 

From a cost perspective, the total cost of care encompasses all spending for the patient—and the patient population as a whole—grouped, benchmarked and analyzed by condition. As the provider mindset shifts to address this model, taking the appropriate steps in terms of patient engagement, technology and workflow are the key first steps to value-based success.

Patient engagement

Organizing care teams of clinical and non-clinical staff around a value-based delivery model sets a solid foundation for population management. Teams track patients throughout their care cycle and establish a tailored process for patient outreach and engagement. By considering the patient’s experience beyond the office, care teams can take a longitudinal approach to care delivery to meet value-based targets.

Healthcare technology

Managing the overall health and care delivery for a patient population requires an effective technology solution to collect, aggregate and analyze patient data. In addition to aiding in predictive modeling and implementing evidence-based care plans, collecting clean, quality data strengthens your reporting and helps ensure you receive appropriate payments and incentives—while avoiding costly penalties.

Clinical workflow

Establishing effective clinical workflows—both at the micro and macro levels—ensures clear lines of responsibility, establishes best practices for effectively collecting and reporting on required data, and promotes understanding of the comprehensive care requirements for patients and patient populations.

 

As your value-based capabilities mature, the next step in growth is to evaluate which clinically relevant private or public payer reimbursement models to pursue.

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