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Value Based Care

What is Value Based Care?

Value based care are payments that give healthcare providers benefits based on the quality of care they provide to patients. This method demonstrates a shift from fee-for service payments, which reimbursed providers for the quantity of services they delivered. Value based care enables high achieving providers the ability to be rewarded sufficiently by the Centers for Medicare and Medicaid Services (CMS), thus improving their reputations as healthcare providers as well as receiving increased payments.

Some common examples of CMS value-based programs include:

  • Accountable care organizations (ACOs)
  • Alternative Payment Models, like Bundled payments
  • Hospital readmission reduction program

Why is Value Based Care important in healthcare?

Value Based Care is important because it represents a shift in the way care is provided and paid for. Historically, providers were focused on the amount of services they provided (fee-for –service). Under this new model, the emphasis is care quality and patient outcomes over quantity. Value based care provides greater alignment between payers, providers, and patients by focusing on the quality of care and the end result as well as the overall patient experience. This kind of coordinated care may reduce unnecessary testing and lower long-term healthcare costs.