3 Ways Value-Based Care Is Transforming American Healthcare

The American healthcare system is shifting away from traditional fee-for-service (FFS) to a new payment model, one that ties provider reimbursement to patient results rather than the quantity of services provided. This model, value-based care, is gaining traction in the U.S. According to the Health Care Payment Learning & Action Network’s 2023 report on participation in alternative payment models, about 60% of healthcare payments made in the previous year included some form of quality or value component, an increase from 53% in 2017 and 11% in 2012.  

This change to value-based care is transforming the healthcare system and will significantly impact the future of healthcare. Medical practices can expect many benefits from this transformation—but only after fully embracing the shift. That’s why it’s so important to understand and embrace the changes value-based care brings to healthcare. 

Financial transformation 

The traditional FFS model has long contributed to ballooning healthcare costs in the U.S. America’s healthcare spending is nearly twice that of other high-income countries—and despite higher spending, the U.S. has the lowest life expectancy among high-income countries, as well as the highest chronic disease burden, highest number of preventable hospitalizations, and highest rate of avoidable deaths.  

Under the FFS model, the majority of U.S. healthcare dollars paid only for the sickest patients; a comparatively small amount went to disease prevention, health promotion, and other measures with greater probable impact on overall life expectancy.  

However, many changes motivated by value-based care promise significant cost savings. Value-based care encourages team-based care, where providers work together to provide patients with the most effective care at the lowest cost. The value-based payment model also encourages preventive patient care with early interventions, which cuts costs by decreasing the need for invasive procedures.  

Healthcare delivery optimization 

It’s important to note, though, that value-based care is not focused solely on cost reduction. Value focuses primarily on improving health outcomes; cost improvement is secondary. 

With the shift to value-based care, physicians can provide their patients with more proactive care, which can lead to better health outcomes. Value-based care also encourages greater patient engagement, helping them to make more informed care decisions. Researchers at the Robert Wood Johnson Foundation reported that actively engaging patients in their health care made them more likely to manage their health conditions and remain healthy.  

Value-based care’s greater emphasis on patient experience and engagement improves treatment adherence, which improves patient outcomes as well. 

Enhancing patient access to care 

The COVID-19 pandemic taught the healthcare industry an important lesson for making the shift to VBC: that telemedicine can be an effective means of healthcare delivery. Telemedicine can both lower costs and improve access for patients who may have difficulty with face-to-face encounters, such as those with chronic conditions, pain, or mobility issues; it provides a means for immunocompromised cancer patients to access care while limiting exposure to infection. Rural residents are another group that benefit from telehealth. These patients often have decreased access to healthcare and are more likely to die from chronic conditions, but telehealth can provide rural residents with improved access to health and wellness programs, specialists, mental health care, and more. 

Value-based care also improves patient access through its increased focus on team-based care. In value-based care, interdisciplinary caregiver teams work together to deliver comprehensive solutions for their patients’ needs. Research also shows that VBC teams are more likely to increase patient engagement by discussing treatment plans, again leading to improved patient outcomes. They are also more likely to coordinate with community resources to help patients meet healthcare goals. 

Creating greater value for patients & providers 

Value-based care has demonstrated its ability to reduce overhead costs and increase positive health outcomes by improving operational efficiencies, reducing waste, and enhancing the integration of the healthcare system. However, making the initial shift to value-based care can be challenging. Veradigm supports healthcare professionals in providing a higher quality of care, more economically, via the Veradigm Network. 

The Veradigm Network optimizes the synergies found across Veradigm’s internal solutions and others who have joined the Veradigm Network, working together to achieve Veradigm’s mission of Transforming Health, Insightfully®.  

Through the Veradigm Network, Veradigm works to improve access to, transparency, and efficacy of healthcare data to help practices deliver high-quality healthcare to patients. For instance, Veradigm’s Ambulatory Suite offers practices a suite of easy-to-use solutions, including Veradigm EHR, Veradigm Practice Management, and Veradigm FollowMyHealth, to help streamline clinical, financial, and patient engagement workflows. We deliver actionable insights that can help drive improved patient outcomes, reduce out-of-pocket costs, and supplement patient understanding of their disease state and treatment. 

Healthcare is moving toward the shared goal of delivering higher-quality patient care more economically. Achieving that goal might present some challenges along the way, but will result in healthcare that is more effective, more efficient, and more rewarding for both patients and providers.