Value-Based Healthcare and Population Health

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 According to an article released by Fierce Healthcare, Optum Health is growing a new value-based healthcare arm.: July 19, 2023: https://www.fiercehealthcare.com/payers/unitedhealth-taps-company-veteran-lead-growing-optum-health-arm

A primary focus at Optum Health has been the push toward value-based care, and UHG said that in the second quarter, it added nearly 900,000 patients treated under these arrangements.

What are Value-Based Care Models?

Good Books Explaining: VBC and Population Health Models: By Kelly Emrick MBA, Ph.D. (Find on Amazon)




Value-based care is a healthcare delivery approach in which caregivers are compensated based on the health outcomes of their patients. The idea is to reward the quality of treatment above many other services. This contrasts with fee-for-service arrangements, in which clinicians are compensated depending on the number of tests, treatments, and appointments.

The following are the fundamental concepts of value-based care:

  • ·         Focus on patient outcomes and satisfaction rather than service volume.
  • ·         Coordination of care across locations improves efficiency and reduces waste.
  • ·         Analyze data better to understand population health trends and specific patient requirements.
  • ·         To enhance health and avoid unneeded acute treatment, prioritize preventive care and chronic illness.
  • ·         Provider incentives should be aligned via risk-sharing structures that reward favorable results.
  • ·         Value-based care strives to minimize healthcare expenditures per person while increasing outcomes.  In contrast, fee-for-service regimes may promote overutilization without consideration for need or effectiveness.

Value-based care adoption has increased recently, fueled by new payment models from Medicare, Medicaid, and commercial insurers. Examples include accountable care organizations (ACOs), bundled payments, patient-centered medical homes, and pay-for-performance schemes. Many policy experts believe value-based care is critical for addressing growing healthcare costs and unsatisfactory health outcomes.

However, the change has not been without its difficulties. Measuring value and results is difficult. Healthcare professionals often lack the necessary skills, resources, and expertise to be successful in these new initiatives. However, value-based care marks a significant change in emphasis to make the healthcare system more efficient and successful in improving patient health.

 



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