115. Is Value-Based Care Real … Or Just Healthcare’s Favorite Myth?

Описание: Value-based care has been around for a while. While it is a favorite buzzword in healthcare, some are questioning its effectiveness. Is that fair?



About The Podcast:

Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.

Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change.

Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American healthcare.

Marc seeks to help Americans become wiser consumers and navigate the healthcare maze with more confidence and certainty through The Healthcare Labyrinth website and his book of the same name.

Marc is an unconventional Republican who believes that affordable universal access is a wise and prudent investment. He recommends common-sense solutions to reform American healthcare.

Tune in every week as Marc examines the latest developments in the space, offering analysis, insights, and predictions on the changing state of healthcare in America.



About The Episode:

On this episode, Marc discusses value-based care. It has been around for a while. While it is a favorite buzzword in healthcare, some are questioning its effectiveness. Is that fair?



Key Takeaways:

A recent Health Affairs Forefront blog lit a bit of a firestorm when it argued that value-based payments — and even managed care — are not going to solve healthcare affordability.

They missed the fact that healthcare is in the middle of a long, messy, transformational journey — and transformation never looks impressive in the early chapters.

Value-based payments are meant to move us away from the old fee-for-service system — the transactional payment model that has dominated healthcare for decades. That has driven utilization, price, and costs.

And the current system does not prioritize long-term quality or outcomes.

There are various value-based-care (VBC) and payment (VBP) models that have emerged, from ACOs to episodic payments to capitation to partial and global risk funds.

Regions, lines of business, provider type and the size of providers all determine how penetrated VBC or VBP are.

Somewhere between 35% and 45% of healthcare payments today are tied to some form of value-based model. But true risk-bearing arrangements might only account for about 20% of transactions.

Critics of VBC say many pilots haven’t generated dramatic savings, value-based models may be accelerating consolidation and empowering corporate intermediaries, and spending slowdowns don’t appear strongly correlated with VBC adoption.

But there is plenty of evidence that mature VBC models do save and drive outcomes and we just may not be there yet throughout our healthcare system.



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The Healthcare Labyrinth: A Guide to Navigating Health Plans and Fixing American Health Insurance