Using Value-Based Models to Help Improve Health Equity

Susan Harriger, RN, MSW, LSW, CCM – Clinical Program Manager

Health equity is the attainment of the highest level of health for all people.

A health disparity, on the other hand, is an avoidable and unfair difference in health status between segments of the population. Health disparities negatively affect groups of people who have experienced greater obstacles to health based on their race, ethnicity, education, literacy, income level, language, culture, age, sexual orientation, gender identity/expression, disability or geographic location.

Health disparities are also expensive for the health care system. Deloitte estimates that health disparities cost the U.S. approximately $320 billion annually. Left unchecked, this financial impact could balloon to more than $1 trillion annually by 2040.

To best address the obstacles preventing us from reaching health equity for all - providers, payers, communities, governments, and corporations must work together to implement creative solutions that solve the root problem. Although this requires a multifaceted approach, value-based care models serve a critical role, offering health care providers greater flexibility in how they tackle the challenges.

Because of the reimbursement structures of value-based programs, providers can approach patient care more holistically, designing programs to improve access, foster communication, and strengthen patient-provider relationships. Such models also emphasize proactive care and robust information sharing, which can lower care costs and reduce waste—two factors currently ramping up the cost of health inequities. 

Specific strategies that value-based care models support include:

• Virtual Care. Delivering care over the phone or via secure video conferencing allows providers to connect with patients who live far away or may struggle to get to the doctor due to a lack of transportation or poor health. Not every type of appointment lends itself to telehealth, but this modality works well for certain interventions, such as routine follow-ups, mental health appointments, and other visits that don’t require a physical examination.
• Stronger community connections. By partnering with organizations such as food banks, senior citizen groups, and public health agencies, providers can help address some of the social and environmental factors that negatively impact their patients’ health. These resources can help enable healthier food choices, facilitate more social connections, provide greater opportunities for exercise, and connect patients with other interventions that can help them stay healthy.
• Better care coordination. This is a priority for value-based care arrangements. Providers leverage technology to stay in contact with one another and work together to support each patient’s journey toward better health. Robust information sharing also helps avoid duplication and limit waste, which can curb the costs of care. When patients can easily view and share their health care data, it improves care engagement and allows the individual to partner with providers to make educated choices about the next steps.
• More focused time with patients. Because providers who participate in value-based care arrangements are not tied to specific visit types and lengths, they can spend more time with patients, listening to their concerns, and offering targeted education and interventions that meet patient needs. Provider organizations can also use physician assistants and nurse practitioners to handle routine and preventive screenings, allowing physicians to focus on those patients who require their level of experience.
• Enhanced communication between care visits. These models enable the use of care coordinators and patient education specialists, allowing provider organizations to routinely connect with patients outside of the appointment and keep them engaged on next steps regarding their health. Providers can also ensure that everyone in their patient population is scheduled for a physical early in the year—a vital strategy for identifying issues proactively and decreasing costs.

Although value-based care models will not eliminate health disparities on their own, they can be part of a comprehensive strategy to reduce differences between populations and improve the health and wellness of communities across the country.