Implementing a Value-Based Healthcare Delivery
The Healthcare delivery model refers to the mechanisms aimed at providing healthcare services that meet the health-related wants of people. Services in the healthcare sector are delivered and financed by the public and private sectors. The members within a healthcare setting include; Nurses, physicians, nurse assistants, and government-registered dieticians. The issues influencing the delivery of services in various health care systems are related to cost, access, and quality of the services rendered. The nurses play a key role in the decision-making about the right healthcare model to be adopted. They respond to shortcomings in the healthcare sector by proposing a plan to be adopted. The nurse’s intervention is by offering healthcare services that aim at prevention and healthcare at the primary stage, resulting in a cut in costs and increased quality of care. There are different models available for the healthcare transition plan. They include; the fee for service model, bundled payment model, capitated payment model, population-based model, and value-based model. Value-based healthcare framework sensitizes the coo actors of the healthcare system to eye the dimension of service quality rather than relying on quantity (Siddiqi, 2017). Under this healthcare delivery model, the providers of healthcare are paid according to the patients’ outcomes. The clinicians get their payments for promoting the outcomes of this system, their efforts in reducing the burden of chronic disease, and the help they render to patients to help them lead healthier lifestyles. The healthcare programs proven as value-based are important as strategies for reforming the way healthcare is delivered and rewarded. The value-based care is implemented with three goals; to improve healthcare rendering to individuals, improve quality to the populations and lower the cost of healthcare (Gray,2017). The present paper analyzes the need to implement a value-based, its specific roles, and how adopting this model will improve health care delivery and the management of finances.
A value-based healthcare model is vital because the traditional fee-for-the-free model is outdated and calls for replacement. The ideology of quality of service delivered versus the number of services delivered by healthcare providers has been contested for a long. On many occasions, focusing on the totality of services rendered over the value of care has resulted in an increment in the cost of services across the globe. To add to the negativity, the costs associated with the traditional model are not proportional to the outcomes in the health status of patients. Considering the present state of affairs in the health sector, the cost of good health is high, but life expectancy is low. The rate of suicide is also high regardless of the huge spending in the healthcare sector.
Additionally, the burden of chronic diseases is also noticeable, and the obesity rate is also wanting. These healthcare statistics show a need to work and reduce the gap between the value provided in the healthcare sector and the amount of money spent in the sector (da Silva Etges, 2020). A clear way to close the gap is by moving from the traditional healthcare models to a healthcare model that implements the principles of value-based care.
Implementing a value-based healthcare delivery model will impact the healthcare sector in several positive ways. Firstly, health literacy amongst healthcare providers is a component of this model type. Given that a value-based healthcare model rewards technicians according to the quality of services rendered, value-based care will concentrate more on health outcomes. The literacy of health care providers relates to value-based health plan and payer cost savings, biopharmaceutical research, and outcomes of patient’s health. By adopting value-based care, the healthcare providers will be forced to emphasize health literacy to offer quality outcomes for patients. Adhering to health literacy is important in research. It ensures that therapies fit perfectly into the healthcare plan and ensures that the patients are empowered on matters about their health. Meeting these goals to perfection contributes to value-based healthcare and supports the key objective of improved outcomes for patients. Looking at the goal of value-based healthcare to provide quality means that resources in the healthcare sector have to be well catered for. That can only be achieved by engaging literacy in the sector.
The specific roles of a value-based healthcare model include:
- The parents spend less capital to achieve quality health services- managing chronic diseases like high blood pressure and cancer can be very costly for the patients; a value-based healthcare model aims at helping patients cure diseases at their early stages, thereby reducing the tests they may undergo, their visits to the healthcare centers, the procedures they have to follow and helping them to cut the costs.
- Healthcare providers achieve efficiencies, and higher patient satisfaction- patient management and quality in healthcare sectors increase when the focus of healthcare providers is directed to value other than volume.
- The payers will be able to control costs and lower risk- lowering of risks is achieved when its spread across a diverse population of patients. Value-based health service payment acts to increase efficiency by bundling payments that cater to the full care cycle of patients.
- Healthcare suppliers align with the outcomes of patients- the suppliers of healthcare apparatus benefit from being able to align their products and the services they render with pleasing patient results and lower costs. This key selling proposition gave the continued rise in national expenditures on drugs prescribed by healthcare experts. Several healthcare centers are calling for healthcare manufacturers to relate their products to the needs of patients before product supply (Mahajan,2021). This process seems to become easier given the rowing industrial therapies.
- Societies will lead healthier lives while cutting their spending on healthcare services- realistic amounts are spent in assisting individuals in managing deadly diseases and high-cost hospitalization and emergencies needing medical attention. Value-based care holds the promise to cut the general spending on healthcare.
On the aspect of financial management, with the introduction of a value-based healthcare model, there are mechanisms that the healthcare delivery model will utilize to lower costs. With this model, the hospitals and healthcare providers get rewarded according to the outcomes, other than the number of procedures, the patients they serve, or the charges in place. Instead of charging their patients for every treatment or service they offer, the payments are bundled. This is especially applicable in more elaborate medical cases like replacing joints. The electronic medical records associated with the value-based healthcare models are conducted for each patient, thereby eliminating unnecessary tests and procedures and avoiding the repetition of tests. Doctors and other medical care providers are linked through care coordinators to offer services in a more efficient and less waste of time and human effort (Walsh,2019). In this model, the patients move through this highly integrated system more quickly. This will reduce the number of readmissions and reduce trips to the emergency room. The ideologies of value-based healthcare prove a long-term goal of this model. The concepts of this model are proactive to cut down the expenditures on health caregiving, produce more pronounced outcomes in healthcare, and improve the general health and wellbeing of patients.
There are several steps a healthcare organization can undertake to implement value-based care in their health practices. Five key steps directed by the American Medical Association are utilized for any organization that wishes to implement the modern model (Zipfel, 2019). The steps are identifying the patient population and opportunity, designing a healthcare model suitable for the implementation, seeking partnership for success, driving suitable utilization, and lastly, quantifying the impact and continuous improvements. Adhering to these five steps may seem easy but realistically, implementing a value-based care model calls for more than that. The implementation requires to be done through perfect planning. Healthcare technologists and other medics think of weighing between the traditional model and the value-based care model in the course of the implementation. During the implementation of this model, it is always important and advisable for specialists to embrace technology and its advances. The organizations looking to implement this plan need to establish partnerships to ensure that the transition from traditional models to a value-based model is seamless and cost-efficiency.
In conclusion, transiting from the traditional models or rather the fee-for-service to a modern fee-for-value model can either take long or be short-lived, depending on the perspectives of individual organizations. In the course of evolution in the healthcare sector, with more organizations adopting these value-based models, the organizations may notice short-term financial reductions before the long-term fall in the costs. However, the drift from traditional models to a value-based model is voted as the best technique for cutting down the costs of health caregiving while increasing the quality of services in the sector and positively impacting the lives of patients
References
da Silva Etges, A. P. B., Ruschel, K. B., Polanczyk, C. A., & Urman, R. D. (2020). Advances in value-based healthcare by applying time-driven activity-based costing for inpatient management: a systematic review. Value in Health, 23(6), 812-823.
Gray, M. (2017). Value-based healthcare. BMJ, 356.
Mahajan, A., Esper, S. A., Cole, D. J., & Fleisher, L. A. (2021). Anesthesiologists’ role in value-based perioperative care and healthcare transformation. Anesthesiology, 134(4), 526-540.
Siddiqi, A., White, P. B., Mistry, J. B., Gwam, C. U., Nace, J., Mont, M. A., & Delanois, R. E. (2017). A clinical review is the effect of bundled payments and health care reform as alternative payment models in total joint arthroplasty. The Journal of arthroplasty, 32(8), 2590-2597.
Walsh, A. P., Harrington, D., & Hines, P. (2019). Are hospital managers ready for value-based healthcare? A review of the management competence literature. International Journal of Organizational Analysis.
Zipfel, N., van der Nat, P. B., Rensing, B. J., Daeter, E. J., Westert, G. P., & Groenewoud, A. S. (2019). The implementation of the change model adds value to value-based healthcare: a qualitative study. BMC health services research, 19(1), 1-12.