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Value-Based Care in Health Care: Traveling the Path from “Value” to “Outcome”

Authored by: By: Ian Wayton 

When you hear the term value-based care … what exactly does that mean?  

A deal at the grocery store is a “great value.” Extra features at no additional cost in a product are a “great value.” But this isn’t what we mean when we talk about value-based care. After all, in this case, we’re not talking about “stuff.” Value-based care deals with real people and their health considerations, challenges and well-being.  

Ian Wayton, account executive, healthcare at i3 Verticals, recently attended a conference with many of the sessions focused on value-based care in health care. He notes that speakers suggested shifting the terminology from “value-based care” to “outcome-based care.” A subtle change, but a large difference.  

“When we shift from thinking about value-based care to outcome-based care, we’re zeroing in on what helps the patient,” says Wayton. “It’s a little more human, right? Because it’s not about every single interaction with the patient, but instead, it’s about the finish line. What do we want to help this patient achieve? And, of course, that’s improved health outcomes around whatever the patient is dealing with.”  

The way to accomplish that shift, according to Wayton, might involve taking more risks and experimenting in areas that aren’t well charted yet.  

Value-based care in health care: The mental and physical health connection  

The physical and mental health connection isn’t anything new to medical providers. Thirty-seven percent of those with mental health conditions also have long-term physical health issues, according to the Medical Health Foundation. Additionally, mental health is shown to impact longevity. Depression, for example, increases a person’s risk of dying from cancer by 50% and dying from heart disease by 67%.  

As a result, in the context of value-based care, it’s worth examining how these connections impact desired health outcomes. Or, as Wayton explains, we focus on outcomes, but we also need to explore interconnectivity.  

“A patient might require care for a short-term injury,” says Wayton. “Maybe in the past, that meant staying at an inpatient facility. But let’s say the data shows a person has better physical and mental health outcomes with in-home care. In this scenario, we might need to question how we’re treating based on the whole picture, including mental and physical connections.”  

Cost no doubt plays into value-based care, but Wayton points out that by focusing on new connections, we might inadvertently uncover cost-saving opportunities. Providers and payers could work together to design creative solutions that achieve desired outcomes while keeping costs in check.  

Value-based care in health care: Taking more risks to improve outcomes  

At the heart of value-based care is the idea that providers and payers work in lockstep to improve patient outcomes. And while it’s true value-based care has been used for some time, its wider adoption might require some experimentation — and some risk.  

“During two of the conference sessions I attended, the same message was given,” says Wayton. “Just because nobody has done something before, that doesn’t mean you should be afraid to do it yourself.”  

And yes, experimentation does involve risk. But if we look for new connections and applications of value-based care, such as the interconnectivity of mental and physical health, we might uncover new ways to improve health outcomes. 

Of course, this requires value-based care solutions that support data collection and analysis to understand results. But the first step is to uncover these new connections, staying tightly focused on the end goal, which is to improve the

Want to learn more about value-based care and its possibilities? I’ll be at the Open Minds Performance Management Institute later this week. Swing by booth 16 and let’s connect.   

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