Emerging Models of Care that Prioritize Value Based Care

December 5, 2023

As healthcare systems worldwide grapple with rising costs and varied patient outcomes, the transition from volume-centered models to value-based care (VBC) models is becoming increasingly pertinent. This transition embodies a fundamental shift towards a more holistic, patient-centric approach aimed at enhancing the quality of care, reducing healthcare costs, and ultimately improving patient and provider experiences. One critical driver of this change is the adoption of Remote Monitoring Technologies (RMTs). Companies like PatientOne hint at a broader horizon, emphasizing a nuanced approach encompassing people, processes, and technology to tackle healthcare’s existing challenges.

Understanding the Present Challenges:

The first stride towards embracing VBC models necessitates a thorough understanding of the prevailing challenges in healthcare. Provider burnout, tech creep, and subpar patient outcomes are among the issues that need addressing. 

• Provider Burnout: Provider burnout is a serious concern, with many factors contributing to it, including heavy workloads, administrative tasks, and the emotional stress tied to patient care. A report from Medscape mentioned that 42% of physicians felt burnt out in 2020, showing the extent of this issue. Burnout not only affects the healthcare providers but also impacts the quality of care they provide, leading to poorer patient outcomes.
• Tech Creep ‘Tech creep’ refers to the overwhelming amount of technology tools and platforms in healthcare. While these technologies aim to make operations smoother, they often end up burdening healthcare personnel. The constant need to adapt to new technologies, along with worries about data privacy and security, adds to the stress levels of healthcare providers. Technology should help make processes more efficient and not become a barrier to providing care.
• Sub-optimal Patient Outcomes: The ultimate goal of any healthcare system is to produce good patient outcomes. However, disparities in healthcare access and delivery often result in less than satisfactory patient outcomes. A report from the Commonwealth Fund pointed out that the United States, despite spending the most on healthcare, often falls behind other high-income countries in terms of healthcare outcomes. This shows the need to move towards models that prioritize value over volume.

Engaging providers in discussions on how VBC models can help overcome these challenges is a crucial step. By making these issues relatable, providers can better understand the benefits of VBC models, creating a supportive environment for the transition toward value-driven care models. 

Emerging Models of Care:

New care models are emerging with a spotlight on value-based care, emphasizing improved patient outcomes and provider experiences. These models are seen as remedies to the current challenges, fostering an environment where providers can thrive while delivering value-driven, patient-centric care.

• Remote Patient Management (RPM): RPM is a model that aligns well with the core tenets of VBC, allowing healthcare providers to monitor and advise patients remotely. By leveraging RMTs, providers can proactively manage chronic conditions, adjust treatment plans in real time, and prevent avoidable hospitalizations. This model exemplifies how technology can be harnessed to deliver value-based care efficiently.
• Accountable Care Organizations (ACOs): ACOs are groups of doctors, hospitals, and other healthcare providers who come together voluntarily to provide coordinated care to their Medicare patients. The goal is to ensure that patients get the right care at the right time while avoiding unnecessary duplication of services and preventing medical errors.
• Telehealth: Telehealth, accelerated by the advent of the pandemic, has become a cornerstone in providing accessible healthcare, especially in rural or underserved areas. It facilitates virtual consultations, follow-ups, and sometimes even remote treatment, making healthcare more accessible and less time-consuming for both patients and providers.
• Integrative Solutions: PatientOne, and other companies are introducing integrative solutions that amalgamate people, processes, and technology to address healthcare challenges holistically. For instance, 24/7 remote patient monitoring, home visits through mobile units, and an always-on network are parts of comprehensive solutions aiming to enhance patient care, reduce costs, and improve healthcare providers’ efficiency.

Financial Implications and Benefits:

Shifting to Value-Based Care (VBC) models has various financial advantages. One of the principal merits is the reduction in care costs coupled with enhanced operational efficiency results in substantial savings for healthcare providers. These savings can be channeled back into the system to augment patient care quality further. Additionally, this transition paves the way for the emergence of new revenue avenues as healthcare entities explore innovative methodologies to deliver value to both patients and payers.

A collaboration with companies like PatientOne amplifies these financial benefits. PatientOne, through its integrative solutions, not only aids in diminishing healthcare delivery costs but also unveils new revenue channels. By optimizing the healthcare delivery process and leveraging Remote Monitoring Technologies (RMTs), healthcare providers can diversify their service offerings. This diversification, supported by real-time data and insights from PatientOne’s platform, enables healthcare providers to offer value-added services like remote patient monitoring, chronic care management, and virtual consultations.

These new services are not only aligned with the patient-centric approach of VBC models but also provide an opportunity for healthcare providers to generate additional revenue. For instance, remote patient monitoring allows for proactive management of chronic conditions, which in turn, can reduce emergency room visits and hospital readmissions, resulting in cost savings. Moreover, it provides a platform for healthcare providers to offer personalized care plans and consultations, creating a new billing avenue.

Furthermore, the data analytics and insights provided by PatientOne can help healthcare organizations identify operational inefficiencies and areas for improvement, which when addressed, can lead to cost savings and improve care delivery. By doing so, healthcare providers can significantly enhance their operational efficiency while ensuring that patients receive high-quality care.

Future Trends:

The shift towards Value-Based Care (VBC) models, accelerated by Remote Monitoring Technologies, symbolizes a significant move toward a more efficient, patient-centric healthcare ecosystem. As we look towards the future, technological advancements like Artificial Intelligence (AI), Machine Learning (ML), and Blockchain are set to play a pivotal role. AI and ML, for instance, will enhance predictive analytics, facilitating more proactive and personalized care. On the other hand, Blockchain could provide solutions to data security and interoperability challenges, ensuring a seamless and secure data exchange among various stakeholders.

The acceptance of telehealth and remote monitoring is projected to broaden, diminishing geographical and accessibility barriers enabling timely and continuous care, especially for patients in remote or underserved areas. The convenience and cost-effectiveness of virtual care will continue to drive its adoption, making healthcare more accessible.

The focus is also shifting from merely treating ailments to managing health holistically. This involves a more integrated approach to healthcare, which encompasses not just medical care, but also behavioral health, social determinants of health, and preventive care. Such a holistic approach resonates with the ethos of VBC, aiming to enhance the overall well-being of individuals rather than merely addressing diseases.

On the policy front, regulatory frameworks are expected to evolve to support and promote the adoption of VBC models. This includes providing incentives for adopting value-based practices, ensuring data privacy and security, and creating a conducive environment for multi-sector collaborations.

The principles of VBC are likely to influence global health initiatives, extending beyond borders. Lessons from VBC implementations could inform global strategies to address healthcare challenges, fostering a worldwide movement towards more equitable, efficient, and patient-centered healthcare. The collaborative efforts of healthcare providers, payers, and technology firms are catalyzing this transformation, promising a new era of healthcare delivery centered around enhanced patient outcomes and reduced healthcare costs.