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September 17, 2024

Value-Based Care Has Bipartisan Backing—How Do We Turn It Into Reality?

It’s election season in the U.S., and Americans can’t agree on much. The need for a better healthcare system might be the exception.

Across the political spectrum, there’s support for a healthcare system that prioritizes patient experience and outcomes.

This vision is captured in the value-based care (VBC) model, where providers are paid for the quality of care delivered, not the quantity of services. VBC is associated with a better patient experience, improved health outcomes, and lower costs.

VBC is making headway in the U.S., but progress is slow. As satisfaction with U.S. healthcare nears all-time lows, legislators and providers are searching for strategies to speed up adoption.

Paying More, Getting Less: The U.S. Healthcare Paradox

The U.S. spends more of its GDP on healthcare than any other country—nearly twice the per capita average of other advanced economies. Yet, it doesn’t deliver the best results.

The Commonwealth Fund ranked the U.S. healthcare system dead last among high-income nations in healthcare performance. It falls behind in areas like access to care, health equity, and patient outcomes.

Why does the U.S. spend so much and get so little in return? Many experts point to misaligned incentives under our outdated care delivery and payment model.

Much of U.S. healthcare operates under fee-for-service, where providers are paid for each service they deliver. This system rewards quantity over quality: the more services provided, the higher the compensation.

The biggest drawback of fee-for-service is its failure to incentivize proactive care. Instead of preventing health issues before they arise, our system focuses on treating problems after they develop.

The U.S. leads developed nations in preventable deaths. Shifting to value-based care could help address this by reorienting the healthcare system around proactive strategies.

Laying the Foundation for Value-Based Care

In Congress, legislators from both parties are advancing bills to support the adoption of value-based care. This includes the Value in Health Care Act, which expands incentives for physicians to engage in value-based, alternative payment models.

But regulation is just the start.

For VBC to really take root, healthcare providers need to embrace strategies that support a proactive approach to care delivery.

Here are the key opportunities:

Expand Primary Care Infrastructure

A proactive healthcare system hinges on a strong primary care foundation. Adults with a PCP experience fewer hospitalizations, better outcomes, and lower costs.

Many Americans lack access to primary care, and they miss out on proactive screenings and chronic condition management. This leads to preventable emergency room visits. By expanding access to primary care through mobile and virtual healthcare, we can help prevent these costly and often poor-outcome emergency interventions.

Embrace Technology, But Recognize the Importance of a Hybrid Approach to Care

Technology can make healthcare more efficient, especially by expanding access and improving decision-making.

Telehealth tools enable patients and providers to stay connected, even in areas with limited access. To deliver truly effective care, a hybrid approach that combines telehealth with a clinician that provides in-home treatments can support early intervention, improve the patients’ experience, and reduce the burden on hospital emergency rooms.

Predictive analytics and AI enhance how clinicians analyze patient data. These technologies identify high-risk patients and provide real-time insights, helping providers make more proactive decisions.

Support Care Coordination & Transitional Care Initiatives

Patients with chronic conditions and recent hospital stays often find themselves back in emergency rooms due to poor care coordination. They lack the support needed to manage their health in outpatient settings, and their various providers are often unaware of how their health needs intersect.

Better care coordination ensures that providers are aligned and patients receive the support they need to manage their health outside the hospital, reducing the risk of readmission.

How Proactive Care Can Fix a Flawed System

Across the healthcare system, there are countless examples of proactive care advancing the core mission of VBC: improving patient outcomes while reducing costs.

This philosophy drives our work at DocGo, where we’ve invested in methods and technologies like mobile medical teams, virtual monitoring, and a platform that enables the efficient delivery of care.

The impact of these efforts is clear. Last year, our teams prevented over 54,000 unnecessary emergency visits through proactive care strategies—saving patients and health systems an estimated $167 million.

VBC enjoys widespread bipartisan support for a reason. Our healthcare system has flaws—but they’re largely fixable. By shifting our focus from reactive, costly interventions to proactive, outcome-focused care, we can help ensure patients across the country have access to high-quality healthcare at an affordable rate.