We are transitioning from a fee-for-service healthcare system to a value-based one. This new approach is not well understood, particularly by patients. Value-based care is characterized by the documentation of organizational efficiency and effectiveness combined with positive outcomes for patients. One of the major goals is cost-savings. This is in contrast to fee-for-service where providers decide which services are provided to patients with insufficient attention to outcomes. In line with these changes, some provider organizations are marketing themselves as value-based organizations. Details about this were provided in a recent article (see: Paladina Health acquires Activate Healthcare, creating large provider of value-based care) with a excerpt below:
Paladina Health, a direct primary care services company based in Denver, has acquired Indiana-based Activate Healthcare, a provider offering customized services to employers and unions for preventive and primary medical care. The collaboration creates one of the largest providers of value-based primary care across the U.S., serving more than 170,000 patients in 18 states....With a growing focus in the marketplace on alternative care delivery models that are patient-centric and value-based, Activate Healthcare has been cited as one of the faster-growing organization-based primary care providers...."This partnership underscores the need for innovation and change to improve the health and well-being of Americans while realizing medical cost savings for employers and unions within the healthcare delivery system," said Paladina Health CEO Chris Miller.
This approach by Paladina Health and Activate Healthcare strikes me as ground-breaking. They describe themselves as value-based and promise better care combined with a low spend. Such an approach is obviously attractive to companies that contract out the primary care for their employees to these companies. Here are two quotes from the Activate Healthcare web site:
Aligned Incentives
We incentivize our physicians based on quality of care, rather than quantity of services delivered. Our physicians' accountability for the right metrics helps us deliver increased access and engagement for patients—this results in improved health outcomes and healthy, more efficient healthcare system use.
Data-Driven Approach
Our data-driven approach manages overall risk, including population health management, risk stratification and proactive outreach and communications. With this approach, we are able to address the specific health needs of your population—enabling us to drive health outcomes, lower cost and improve patient experiences.
Whether all of this is mere marketing hype will become apparent in time. However, I think that it's an important trend and other health systems may be headed in the same direction. The executives of these health systems will be turning to their quality leadership and IT departments to supply the data to document that they are delivering on the goals of improved outcomes, lower cost, and improved patients experience. Some of this data can be supplied by population health systems (see: Population Health Management: Systems and Success). The clinical diagnostic departments like pathology and radiology will also be key players in this data collection and documentation process.