posted by Alicia Caramenico
on April 1, 2019
Health care costs shouldn’t be a financial burden for families. By focusing on value and innovation, Americans can get the care they need when they need it—at a price they can afford. Value-based care is one key way health insurance providers make this happen, by ensuring doctors are rewarded for better patient health—not for delivering more health care services.
How does health insurance providers’ commitment to value lead us toward the goal of greater quality and affordability? Below are some examples of value-based care initiatives.
The patient-centered medical home replaces one-off, episodic care with a sustained relationship between patient and doctor. The concept involves insurance provider partnerships with medical groups to establish a medical home for patients, which studies have found provide costs savings and quality improvements.
In accountable care models (ACOs), insurance providers partner with health care provider organizations that agree to be held responsible for the—or share in the risk of—quality, cost, and overall care for a defined population of patients and are eligible to share savings if they meet certain quality and performance goals. The ACO model aligns incentives with providers to deliver efficient and appropriate care for their patients while achieving improvements in patient outcomes.
The use of a bundled payment involves paying providers, or a group of providers, based on defined episodes of care, which include associated health care services under a single fee or payment. Bundling payments better aligns incentives for hospitals, doctors, and other clinicians with cost-efficient, high-quality care delivery.
Moving the payment system from volume to value will better serve consumers, provide access to the best care possible and reduce unnecessary care. And these efforts—nationally, regionally, locally—help to achieve that goal. Delivering value for patients is of utmost importance. Insurance providers continue to work to build a better health care system.