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Value-Based Care: Key to Transforming the US Healthcare System

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By Kyle Wailes
Chief Executive Officer, Wellvana Health
11.02
Recent News, Thought Leadership
As we enter year three of the Covid-19 pandemic, healthcare remains at the forefront of Americans’ minds. The last three years have highlighted the shortcomings in our nation’s current fee-for-service model. It’s clear our existing healthcare infrastructure is in dire need of transformation – and luckily, there is a solution: value-based care.   The current U.S. healthcare system, characterized by a legacy of transactional, fee-for-service medicine, is unsustainable. In a system where providers are paid by payers based on the number of patients, tests, and procedures they conduct, quantity of care is rewarded over quality. In order to put patients back at the center of healthcare, the focus needs to shift to the quality of care provided and the health outcomes they deliver. And thanks to a series of technological, market, and policy advancements, our country has a solution.
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Value-based care provides a vital stepping stone to transforming our healthcare system. 

Here’s why:

1)            Quality care reduces costs

In contrast to the transactional, fee-for-service model, value-based care (VBC) reimburses providers for proactive and comprehensive medicine. By keeping the focus on patient outcomes, the VBC model rewards preventative care and keeps patients healthy longterm. In the American healthcare system, Medicare spending accounts for 20 percent of national healthcare spending and 12 percent of the federal budget. VBC is an answer to significantly improving patient outcomes which, as a byproduct, reduces costs and shores up our resources so future generations can receive the benefits they deserve. Policymakers have recognized the strengths of this approach, with the Centers for Medicare & Medicaid Services (CMS) committed to advancing value-based payment programs to promote the delivery of high-value care by clinicians. 

2)            The pandemic highlighted the weaknesses of fee-for-service models

When the pandemic first gripped the U.S. in early 2020, many fee-for-service physician practices and health systems nationwide saw their patient volume drop dramatically as they were forced to defer and delay non-emergency and routine care. This dramatic drop in patient volume financially crushed providers. A survey done by the American Medical Association conducted in October of 2020 reported that medical practice revenues plunged an average of 32 percent since the beginning of the public health crisis. By contrast, the pandemic has had a limited fiscal impact on value-based care systems. Compared to their colleagues in traditional fee-for-service arrangements, providers in value-based care arrangements were able to focus on delivering quality care with the assurance of sustained income during the crisis. 

3)            Integrating Technology has Never Been So Easy

Some providers have historically been wary of value-based agreements because oftentimes high barriers to entry make it difficult to achieve success, especially in the initial years. Many practices don’t have the financial, technological, or dedicated staff resources to learn and maintain these arrangements. Enter Wellvana. We offer healthcare providers the technology, analytics, and dedicated human resources they need to manage risk, improve efficiency, and ensure profitability. Our unique model connects partners with the legal structure and strategic insights they need to successfully engage in VBC agreements. What’s more, Wellvana understands that healthcare is local and there is no one-size-fits-all approach to healthcare solutions, which is why our flexible offerings meet the physicians where they are to help them get to where they want to be. The result is lower overall healthcare costs, more satisfied providers, and better health outcomes for patients and entire communities.

As the fault lines of the fee-for-service model become increasingly evident, value-based care is poised become the dominant model for providing, receiving, and paying for American healthcare. Wellvana is helping to simplify this transition by supporting an ecosystem of providers with technology-enabled services, dedicated resources, and financial support. This is the model that will help deliver the change our healthcare system needs – lower healthcare costs, profitability for providers, and quality care – for all.

 

Click here to learn more about Wellvana. 

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