Value-based care shifts the existing fee-for-service payment model from the number of patients a doctor sees to a payment system based on quality care and improved results for patients. The value-based care model takes into account the patient’s needs first and measures how health improves.
While the U.S. is a global powerhouse when it comes to medicine, in reality, medicine in America faces two critical and ongoing issues:
The current fee-for-service structure fails to solve either problem. Adding to the burden is the nursing and doctor shortages due to the high rate of burnout among doctors and nurses.
By focusing on value, doctors are able to shift away from billing around volume and, instead, bill against how a patient’s health is improving.
The idea of value-based care was first developed by the American Academy of Pediatrics in 1967 and was considered a groundbreaking concept. By 2008, the Centers for Medicare & Medicaid Services (CMS) started emphasizing the quality of healthcare over the volume of patients seen. Each year, more legislation has been passed to support this overall model including:
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