By aligning incentives with quality and outcomes, value-based care aims to drive improvements in healthcare delivery and promote a more sustainable and effective healthcare system while reducing costs.
Despite spending a significant portion of its gross domestic product on healthcare, the United States has the highest rates of infant and preventable deaths compared to other developed countries, and current systems perpetuate disparities in healthcare access for low-income and underrepresented communities making them more susceptible to adverse health outcomes than the general population.
Experts agree that these longstanding, widespread issues stem partly from the misaligned incentives built into the nation’s traditional, fee-for-service payment model. However, value-based care models are working to overcome these historical challenges by reducing costs, improving care quality, transforming healthcare delivery and broadening access.
The Old Way: Fee-For-Service (FFS) Payment Models
Before the advent of value-based payment models, traditional healthcare models relied on the fee-for-service system where healthcare providers and hospitals are reimbursed based on the number of services and procedures they provide. This model focuses on the sole number of services provided, often resulting in high out-of-pocket and health plan costs and unequal patient care. FFS rewards providers for seeing a greater patient pool, incentivizing them to perform more procedures to accrue a more significant reimbursement, ultimately discouraging efficiency, transparency and quality care.
Technology is Revolutionizing Value-Based Care
Technology is transforming the healthcare landscape through innovative solutions that enhance value-based healthcare solutions by improving care quality, patient engagement, and cost-effectiveness.
Electronic Health Records
A foundational component of value-based care models, electronic health records (EHRs) digitize health records and make comprehensive patient information easily accessible to healthcare providers, simplifying recordkeeping and eliminating mistakes. EHRs encourage providers to deliver patient-focused care, transitioning from fee-for-service models where providers are compensated by the funds brought in by their services. Additionally, this model enables data exchange between different healthcare settings to ensure seamless transitions and continuity of care.
Telemedicine
The pandemic accelerated the expansion of telemedicine and the pursuit of value-based care nationwide. Unlike traditional in-person care delivery, telemedicine is a broad term that encompasses email and video consultations, activity-tracking wristbands and mobile apps.
If thoughtfully implemented, telemedicine can benefit all parties involved. For patients, remote care can improve access, reduce travel time and broaden provider availability.
Telehealth is becoming more affordable as payers and providers implement value-based care models as the industry standard.
Care Coordination & Communication
Technology has a profound impact on patient communication and engagement within value-based care models. With the rise of digital tools and platforms, patients now have easier access to their health information, enabling them to actively participate in their care. Patient portals, secure messaging systems, and telemedicine platforms facilitate convenient and timely communication between patients and healthcare providers.
These technologies allow patients to ask questions, seek clarifications and share updates with their providers, fostering a sense of partnership and engagement in their healthcare journey. By promoting seamless communication and providing tools for self-management, technology plays a crucial role in enhancing patient engagement and fostering a collaborative approach within value-based care.
Remote Patient Monitoring
Remote patient monitoring (RPM) is a technology-driven solution that allows healthcare providers to monitor health remotely. RPM devices, such as wearable sensors and mobile apps, collect vital signs, medication adherence data and other relevant health information, allowing for proactive interventions, early detection of potential issues and personalized care management. RPM also reduces hospital readmissions and healthcare costs by preventing complications and promoting timely interventions.
Population Health Management
Value-based care models prioritize population health management, and technology is crucial in achieving this goal. To deliver true value-based care, healthcare providers need insight into the characteristics of both individuals and larger groups of patients, creating tailored, cost-effective interventions based on patients' risk levels.
With the help of technology-enabled population health management tools, healthcare organizations can aggregate and analyze patient data to identify population health trends, gaps in care, opportunities for intervention, recognize at-risk populations, and implement preventive measures. Population health management supported by technology empowers healthcare organizations to proactively address health disparities, improve overall health outcomes, and optimize resource utilization.
Interoperability & Health Information Exchange (HIE)
Interoperability and health information exchange (HIE) are crucial components of value-based care models. Seamless and secure sharing of patient information across different healthcare systems and providers is essential for care coordination, continuity, and efficient decision-making.
Health information exchange platforms facilitate the exchange of patient data in a standardized format, enabling healthcare providers to access comprehensive patient information, reduce duplicate tests and procedures, and ensure that care decisions are based on the most up-to-date and accurate data.
Artificial Intelligence (AI) & Machine Learning (ML)
AI and ML technology have emerged as powerful tools in value-based care, offering vast opportunities to optimize clinical decision-making and healthcare operations. These technologies use algorithms to analyze complex medical data, identify patterns, assist in personalized treatment plans, automate administrative tasks, and detect errors.
As a result, artificial intelligence and machine learning are transforming value-based healthcare delivery by providing customized care, improving diagnostic accuracy, and supporting evidence-based decision-making.
Conclusion
The impact of technology on value-based care is profound and promising. By leveraging innovative solutions such as electronic health records, telemedicine, remote patient monitoring, artificial intelligence and data analytics, healthcare organizations can transform their care delivery, enhance patient engagement, and optimize resource utilization.
To learn more about how technology is driving the future of value-based care, watch our interview with Microsoft on The Health/Tech Edge where we discuss patient data interoperability and value-based care and how they are shifting the healthcare industry to become less fragmented and more integrated.
