As a result of skyrocketing healthcare costs in the U.S., value-based healthcare has emerged as a viable alternative care reimbursement model to traditional fee-for-service (FFS) for health systems and hospitals. Though the pandemic may have slowed the pace of its adoption, value-based care technology implementation continues to be a more cost-effective way of delivering more directed care to patients who need it in a way that improves patient outcomes.
What is Value-Based Care?
Value-based care is a form of reimbursement that ties payments for care delivery to the quality—rather than the quantity—of care provided. It rewards organizations and systems for efficiency and effectiveness of care to drive down costs. First introduced in 2006, the concept of value-based healthcare gained steam in 2010 with the passage of the Affordable Healthcare Act.
This type of care is also centered around the idea of patient-centricity and that a more nuanced approach to care can improve outcomes as measured by things such as reducing hospital admissions and readmissions, improving preventive care, and delivering more personalized care for chronic care patients through connective technologies.
What is the Importance of Value-Based Healthcare?
Health systems, hospitals, and payer organizations can lower costs and eliminate unnecessary treatments and appointments using a value-based care model. In 2015, the Department of Health & Human Services (HHS) said that 20 percent of Medicare payments were made through value-based care. Similarly, the agency found that accountable care organization (ACO) programs using value-based care saved Medicare $417 million while also helping reduce hospital admissions by eight percent.
In another example, Blue Cross Blue Shield in New York used value-based care enablement programs to lower average annual spending for a savings of 12 percent. They also saw the share of their members who met quality criteria for chronic disease management jump from 75 to 85 percent even while national averages dipped.
As of 2019, value-based care models accounted for 38.2 percent of all healthcare dollars spent in the U.S.
Technology and Value-Based Care
The use of technology has been critical to the success of value-based care in helping care organizations and providers close gaps in care and identify patients who need better managed care. When crafting a care system that’s value-based, technology solutions and digital tools create greater operational efficiencies, enhanced communication, and streamlined workflows so that providers can better ensure every patient receives the right care at the right time.
Value-based care technology enables healthcare organizations to administer more pinpointed care at-scale to decrease costs while delivering more individualized treatments for preventive care and chronic care patients. Chronic care conditions impact 50 percent of Americans and in 2020 caring for patients with chronic diseases tallied more than 85 percent of all healthcare costs.
6 Ways Technology Supports Value-Based Care
The rapid rise of telemedicine in March 2020 gave physicians and providers a much-needed “new” tool to apply a value-based care approach to care delivery. Rather than chronic care patients having to book an in-office appointment every routine checkup and recall visit, value-based care technology like real-time video visits afford patients a more convenient and efficient way to receive care. Telehealth capabilities give providers the economy of scheduling more billable yet shorter visits within the same timeframe and options for hybrid care—a combination of telehealth and in-office visits—for preventive care and chronic care management patients. The tool helps drive better outcomes for patients while helping health systems and hospitals increase revenue.
2. Patient Engagement
The key to improved patient engagement in the 21st century is connecting with patients the way they want to communicate. To achieve this, providers and practices are moving toward platform solutions that offer automated tools and a text-first approach to more effectively and efficiently guide patients through each step of the care journey. It’s also been a vital tool to helping providers use features like text appointment reminders and real-time two-way texting. For example, the ability to text chronic care patients’ reminders about taking their medications, scheduling specialist and follow-up visits, and complete important lab work. There is a growing body of evidence surrounding how important patient engagement is to the patients’ health outcomes, so keeping them informed and in close contact is vital.
3. Patient Experience
Perhaps more than other groups, patients impacted by preventive care, chronic care conditions, and social determinants of health (SDOH) want to avoid having a confusing or disjointed care experience. They want clear guidance from the provider across the appointment workflow. Value-based technology solutions like automated patient surveys sent after an appointment enable providers to carefully monitor the quality of the patient experience, assess patient satisfaction, and to identify areas for improvement. Survey feedback helps providers know to what extent patients are having the type of experience and seeing the outcomes that would make them want to recommend the organization.
4. Population Health Management
Population health management (PHM) is a mix of preventive care approaches and connective technologies to ensure patients with chronic diseases receive the coordinated care needed to better manage their conditions. For example, do patients with diabetes receive reminders and notifications to book six-month diabetes checks and annual AIC blood glucose testing? A value-based care approach to population health management might be to use a recall tool to automatically send reminders and notifications to patients based on age or diagnosis. It’s an effective way to help patients with chronic conditions avoid the gaps in care that can lead to hospital admissions and poorer outcomes.
5. Remote Patient Monitoring
Because two out of three patients over the age of 65 have two or more chronic illnesses, providers’ ability to closely track patients’ care is greatly enhanced with remote patient monitoring (RPM) technology. The technology gives providers the ability to collect and analyze actionable physiologic data, such as weight, blood pressure, and pulse oximetry without the need for an in-office appointment. For example, remote patient monitoring allows providers to reach out with a text reminder to a patient to take their medication if their blood pressure is too low. The result is fewer emergency department visits and hospital admissions.
6. Billing and Payments
Making payments for care can be confusing enough for patients without a complex and frustrating system for paying bills. Patients of all ages want to be able to pay their healthcare bills electronically like they do with everything else. One poll found that 80 percent of patients prefer digital bill pay. An online bill payment tool allows providers to text reminders with clickable links to a secure site to make payments. It’s a more efficient approach that saves staff time and providers get reimbursed quicker which helps recover revenue faster.
Value-Based Care Technology Delivers Better Outcomes
Driving a digital, value-based healthcare model improves the experience of patients, doctors, healthcare administrators and staff. In the end, the goal of value-based care is to deliver more patient-specific communication and treatment to improve outcomes at lower costs. Proper care management isn’t tied to a single visit or treatment but is an ongoing process of frequent touch points to ensure patients receive targeted and appropriate care. Solutions like a comprehensive patient engagement platform are the pathway to organizations connecting better with patients and gaining the operational efficiencies for better coordination of care and improved patient outcomes.
To learn more about using technology to improve value-based care, check out the guide, "The Truth About Patient Recall."