What Value-Based Care is and Why It Might Matter to Your Health

Advanced technologies and improved science continue to radically change healthcare for the better from gene therapy to new antibiotics, remote monitoring to wearable robotic devices. Yet, as important as these breakthroughs are to healthcare, they are only part of healthcare delivery. What’s the rest? People. From doctors to nurses, health coaches to behavioral specialists, it’s the people who often determine a great healthcare experience for you.

Health is a complicated web of lifestyle, genetics, environment and healthcare. Navigating traditional healthcare models may be an even more complex tangle to unweave due to patient-driven coordination between several providers, specialists, labs, pharmacies and facilities.

A New Kind of Care

More and more providers and policy makers have recognized a need to improve how healthcare is delivered. The Centers for Medicare and Medicaid Services (CMS), the federal government agency that manages Medicare and Medicaid, has developed value-based programs which aim to deliver better care for individuals, better health for populations and lower costs.

Rather than pay providers based on the number of services they perform, value-based programs reward providers for the quality of care they provide. The value-based care model focuses more on quality than quantity in an effort to improve health outcomes.

Why Value-Based Care Matters

More Collaboration, Increased Transparency

Value-based care encourages providers and payers to collaborate, which can lead to greater transparency. For example, value-based care uses electronic health records to securely share patients’ data among multiple parties including physicians, health plans, hospitals and communities to help prevent information silos. This integrated, coordinated system helps create a unified approach to improve health outcomes. In addition to this collaborative exchange of information, value-based care typically offers more coordination at the provider level through care teams, which provide additional support through a health coach, nutritionist and/or behavioral health specialist.

More than Medicine

Value-based care recognizes that social and environmental factors such as food security, social connections and transportation can contribute to your overall health. In many cases, lacking these factors could be “at the root of why patients aren’t achieving the best health outcomes” according to Humana’s most recent value-based care report. Nutritious foods and social ties can help support your health and well-being. Reliable and accessible transportation helps enable you to access healthcare, healthy food options and maintain social connections. Value-based providers may consider lifestyle adjustments —not just procedures and pills—to help you lead a healthier, happier life.

Coordinated Care for Complex Conditions

Humana’s Value-Based Care Report shows that 90.5 percent of Humana members have at least one chronic condition and 82.6 percent have at least two. Chronic conditions such as diabetes, hypertension and heart disease may present ongoing physical, emotional and social demands that can take a toll on both you and your family. Value-based care might offer greater care coordination and support to help combat chronic conditions. Humana found that patients in a value-based setting were more likely to adhere to hypertension and diabetes medications as instructed than those of non-value-based doctors. Value-based care could help lead to improved health and well-being, especially if you have a chronic condition.

What Value-Based Care Means for You

Quality care is defined by the Committee on Quality Healthcare in America as “care that is safe, effective, patient-centered, timely, efficient and equitable.” It’s “also a key component of the right to health, and the route to equity and dignity…” You deserve quality care and the opportunity to achieve your best health.Better Health, Happier LifeValue-based care may help lead to positive changes in your health and happiness. Humana has shown that members in value-based care settings receive higher rates of preventative screenings, fewer emergency room and hospital admissions and greater adherence to medications than those in non-value-based care settings, all of which contribute to lower medical costs. Humana found a 20.1 percent savings in value-based care programs and expenses compared to Original Medicare.

When you’re healthier, you can enjoy a better quality of life. You can be more active, whether that’s cultivating your garden, learning how to paint, taking a yoga class with friends or marking travel destinations off your bucket list. You can be more engaged with your friends and family and celebrate the simple joys and major milestones alike. Better health and greater happiness could be within your reach. It’s up to you to reach for it.

Want to know if you’re getting the right healthcare for you? Check out our article What the Right Kind of Care Looks Like.

Ready to explore your value-based care options? Contact us.