Shifting to a Value-Based Care Model in Healthcare

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We are seeing a shift from the traditional fee-for-service model to a more value-based care approach. The value-based care model aims to establish a long-term relationship between the physician and patient.

At HIMSS, Dana Bensinger, MSN, RN-BC, client solution executive at CTG, an information technology staffing and solutions company, told Inside Digital Health™ that the ultimate goal of value-based care is for physicians to prevent patients from getting sick in the first place.

One value-based care initiative rolled out deals with the diabetic population and keeping that subset of patients healthier for longer periods of time, but really try to prevent the chronic condition to begin with.

And electronic health records (EHRs) can be leveraged to improve patient outcomes, Bensinger said.

EHRs collect a lot of actionable data that help physicians manage the health and wellness of patient population. As we switch to value-based care, we are looking at the data we are collecting, how we are collecting them and how they are actionable.

In the past, we have collected data on the social determinants of health, but they were not actionable enough.

With the fee-for-service model, physicians would ask a patient about their smoking habits — if the patient currently smokes or if the patient has in the past — and the results were not used for anything.

In a value-based care model, it is recognized that if a patient smoked 20 years ago but stopped, the patient is still at risk for lung cancer at a later age, so the patient needs to be screened and know that the risk is present.

And of course, interoperability plays a role in value-based care.

When it comes to value-based care, physicians now need to be able to reach outside of the health system and into the community, Bensinger said. If a patient goes for a follow-up outside of the physician’s health system, the physician wants to be able get information back about the patient’s progress and know if the outside health system or program the patient went to should be referred to for future patients.

“We need to reach outside our walls and connect with areas that we didn’t think about as a referral point for us,” Bensinger said.

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