What Is Value-Based Care?
Value-based care is a healthcare payment model that rewards providers for patient health outcomes rather than the number of services performed. It focuses on preventive care, care coordination, and reducing unnecessary treatments to improve overall patient well-being.
How does value-based care work?
- Quality over quantity: Providers are incentivized to deliver effective, efficient care instead of billing for each individual service.
- Preventive focus: Encourages early intervention and chronic disease management to prevent costly hospitalizations.
- Cost efficiency: Aims to lower healthcare expenses by reducing unnecessary procedures and improving care coordination.
Does Medicare cover value-based care?
Yes, Medicare incorporates value-based care through several programs:
- Medicare Advantage (Part C): Many plans use value-based payment structures, rewarding providers for efficiency and patient outcomes.
- Accountable Care Organizations (ACOs): These groups coordinate care to improve outcomes while reducing unnecessary costs under Medicare Shared Savings Programs (MSSP).
- Bundled Payments for Care Improvement (BPCI): Medicare pays providers a fixed amount for an entire episode of care, encouraging cost-effective treatment.
- Hospital Value-Based Purchasing (VBP): Adjusts Medicare payments based on hospital performance metrics like patient satisfaction and safety.
How Solace can help
Value-based care can be complex, especially for Medicare beneficiaries navigating different programs. A Solace advocate can help you understand your options, find providers who participate in value-based models, and coordinate care to ensure better health outcomes.
What to do next
Need help finding a provider who participates in a value-based care model? Talk to an advocate.