One of the main goals of the Affordable Care Act, passed in 2010, was to try out new models of paying for healthcare in hopes of benefitting patients as well as hospitals and providers. One such model, which you may have heard while looking for different healthcare providers, is called the “value-based care” model.
Let’s talk about what valued-based care is, what it was designed to replace, why it benefits you as a patient, and where you can go across Central Florida and South Florida for outstanding primary senior care that focuses on keeping you healthy.
What Is Value-Based Care and What Is It Replacing?
Before the Affordable Care Act, the most common healthcare payment model was the “fee-for service” model. In this model, healthcare providers are paid based on each service performed. The focus, therefore, is on the quantity of care, as the more tests or procedures performed, the more providers are paid.
Value-based care is a newer model of healthcare payment that is designed to promote quality of care, rather than quantity. In this model, healthcare providers are paid based on health outcomes of their patients. In this way, value-based care is focused on quality of care and preventative care, in addition to treating disease/illness as it comes up.
The long-term goal is to lower the amount of hospital re-admissions and surgeries, because the care was appropriate and effective the first time. This saves money for both patients and hospitals/caregivers.
This model incentivizes all providers who are involved in a patient’s care to work towards the patient regaining full health in order to receive the most payment.
Models of Value-Based Care
The Center for Medicare & Medicaid Services (CMS) has introduced a variety of types of value-based care models, and private insurance companies also have similar models. The CMS models include:
Accountable Care Organizations (ACOs)
In this model, physicians, hospitals, and other healthcare providers participate in a network that shares savings if they provide high-quality care. They can therefore decrease cost by providing preventive care that avoids costly surgeries and mitigates disease.
Bundled Payments
Payment for all healthcare services which are provided for an entire episode of care are “bundled.” For instance, after a surgery, the cost to pay the surgeon, anesthesiologist, and hospital are all paid together instead of separately to each provider.
Patient-Centered Medical Homes
In this model, patient care is coordinated through a primary care provider, and any other specialty providers needed are added into a team of providers that support the patient.
How Value-Based Care Benefits Patients
Value-based care is extremely beneficial to patients, because the main focus is to prevent diseases from occurring in the first place – and without lots of unnecessary tests. This is accomplished by educating patients on proactive actions such as diet, exercise, and healthy life habits to promote wellness and prevent disease.
This is especially beneficial for people who have chronic conditions; because value-based care models incentivize providers to work together, it ensures that the most expert individuals are the ones responsible for the various aspects of your care.
What Does Value-Based Care Look Like?
An easy example of value-based care is the patient-centered medical home. For instance, if you have diabetes, under this model you would work with a primary care doctor to oversee all aspects of your health, an endocrinologist to manage your insulin levels, a nutritionist to create a diet that helps you regulate your blood sugar, a physiologist to design a sustainable exercise program, and possibly even a therapist to help you through psychological and emotional implications of having a chronic illness.
While it may seem quite expensive to have this many providers involved in your care, in the long run it is cheaper for you – because all these providers are essentially saving you the cost of treating extensive health complications that warrant hospital stays. This is accomplished by helping you keep you condition in check.
Value-Based Care in South Florida and Central Florida
Value-based care is centered around each patient’s health and wellness. It pays providers based on these factors rather than for the number of services they provide; it therefore promotes quality over quantity.
At Palm Medical Centers, we are all about maximizing patient wellness and avoiding unnecessary tests and procedures. We offer value-based, senior-focused medical care at our many locations throughout Central Florida and South Florida. Our providers and staff are committed to the highest quality of service, compassion, integrity, performance, and teamwork to provide you with the best care possible.
To schedule an appointment, call us today at (833) 500-7256, or fill out our request form online now. We look forward to seeing you at one of our offices and helping you on your health and wellness journey!
