Why Value-Based Care Is Here to Stay

While policy makers in Washington continue to debate healthcare payment reform and fight over which components of the Affordable Care Act they will fund and implement, health system and hospital administrators across the country are doing their best to run a stable business against this backdrop of uncertainty, and move forward with initiatives designed to provide better care at lower costs.

The administrators we speak with want to move away from the fee-for-service model of the past, which financially rewarded them for increasing the traffic in their facilities instead of for achieving the best health outcome possible for each patient.

They’re focused on implementing value-based care initiatives regardless of what happens on Capitol Hill. We applaud this, and we are pleased that patient engagement is playing a significant role in making care teams more efficient and in reducing the number of medical complications and unnecessary hospital readmissions.

We’ve summed up why health systems continue to move in this direction and consider value-based care to be the best path forward for their organizations.

Improved care coordination

Patient journeys in America’s healthcare system are complex and fragmented. They often require hospitalizations, physician appointments, rehabilitation facilities, physical therapy, new medications and more. Navigating the healthcare system is hard work. Physicians, nurses and other care team members who strive to integrate their delivery and provide for better coordination reap great benefits in patient service and quality.

Patient engagement platforms are an important tool when it comes to creating efficient, coordinated care teams capable of collaborating across care settings with the patient informed every step of the way. Automated, daily engagement gives all care team members access to the same insight into their patients at the same time, which means team members can hand patients off to one another seamlessly, without worrying that vital information will be lost or buried.

Patient engagement also means keeping tabs on patients once they have been discharged from care, and care teams can be proactively notified should their patients experience the types of complications that can lead to a hospital readmission.

Those engaging their patients with GetWell Loop are seeing a 45% drop in hospital readmissions and a 54% reduction in medical complications, which works well for healthcare organizations and their patients. 

Watching costs and tracking patient outcomes

Engagement with patients can lead to reductions in call center volume and cancellations of follow-up visits, as well as an increase in newly scheduled visits, which can generate additional revenue.

Patients who are engaged by their care team daily have no problems getting their questions answered, which means far fewer patients place calls to their providers. Providers using GetWell Loop have found that not only are fewer calls coming in, but most inquiries that do come in can be fielded by front-line staff instead of physicians. This leads to a reduction in the need for in-person visits. Patients who get the information they need, and get their questions answered, are less likely to require routine follow-up visits after discharge, which opens slots on the calendar for new patients. This not only cuts costs, but boosts health system revenue and is more convenient for patients.

GetWell Loop also does much of the hard work of collecting Patient Reported Outcome Measures (PROMs). In a typical healthcare setting, this work is completed by care teams, adding significantly to their workload. Providers using GetWell Loop see a 74% completion rate for PROMs and do not have to budget additional staff hours to get their completion rates to this level.

Bundled payments

Regardless of the recent final decisions on mandatory CMS bundled-payment programs and pending announcements to extend and broaden the voluntary bundled payment programs, health systems are continuing to invest in the capabilities to drive more efficient and cost effective care.

Under bundled payment programs, healthcare providers receive a fixed payment for all services provided to patients from their time of admission until 90 days after their procedure, with no additional payments for complications, readmissions, or post-acute services. 

While health systems were initially cautious about these programs, bundled payments have now become so well-liked that many organizations are sticking with it, even though for many it is no longer mandatory. Almost half of the 799 participating healthcare facilities across the country found they could earn more money for total joint replacements and became eligible for government bonuses, while improving quality and reducing unnecessary healthcare costs.

Meeting cost goals like these — whether they are set by CMS or not — is something far more easily accomplished by care teams that can easily obtain and share knowledge about patients. 

Value-based care is here to stay

Healthcare has become a highly charged political issue in our country, and the future of payment reform remains uncertain.

Healthcare organizations are tending to volumes of patients, while at the same time thinking strategically about how to increase their market share. They scarcely have time to follow every twist and turn of the debate in Washington.

But instituting a system of value-based care is something that resonates with physicians and administrators. They want to see rewards for delivering quality care, not quantity.

We agree wholeheartedly, and we are proud to be part of this process for a large and growing number of healthcare providers.

Let’s strive for quality. If we continue to amplify the voice of the patient, and use the valuable information that we can now collect from patients at scale, we will get there.