What Is Value-based Care? (or Quality-focused Care)

What is value-based care?

For years, the Centers for Medicare & Medicaid Services (CMS) has been testing new programs called “models” to provide a better care experience for you. The new care approach, value-based care (we’ll call it quality-focused care, as recommended by the United States of Care), is believed to change the old way care is delivered. In this article, we will guide you through this new approach to care and how it can benefit your health.

Quality-focused care is a new health care approach that rewards doctors and providers for delivering higher-quality care, improving patients’ overall health, and helping facilitate more coordinated care experiences around patients. Compared to what many use as their current care model (often referred to as fee-for-service), the new approach prioritizes the quality of care over the quantity of services. It encourages a more personalized experience tailored to your unique needs. Now, let’s break down the four benefits it provides and what that looks like for you.

Benefit 1: Focusing on your total well-being

Quality-focused care looks at your total well-being. It's not just about treating one sickness but understanding everything that affects your health. For example, doctors will look at regular physical health issues, such as diabetes and heart disease, as well as your mental health, such as experience of burnout or anxiety.

This care approach also considers other factors that might impact your overall wellness, like where you live or what you eat. Do you have clinics located near you? Is it easy for you to get there? Do you have access to healthy food? Instead of focusing on your clinical symptoms, this approach allows your doctors to take a broader view of your health and get to know you better.

What does it look like for you?

Your appointment with a doctor feels more personalized and attentive because they can spend more time understanding and addressing your health concerns thoroughly.
You may be more likely to get a doctor's appointment when you need one, thanks to extended office hours some of the practices adopt.
You might feel more supported between visits with your doctor. This could mean getting follow-up phone calls from a nurse or even receiving at-home visits when appropriate.

With an approach that cares about you as a whole person, you are more likely to understand your health better after seeing your doctors and receiving personalized follow-up care from the clinical team.

Benefit 2: A more coordinated patient experience

Quality-focused care is about improving your health care and making it a better experience. Remember how frustrating it can be to go from one doctor to another, doing the same tests again, and repeating the same information?

This new way of care aims to fix that by getting all your health care team – like your family doctor, specialists, nurses, and therapists – to work together. Thanks to new technology, they can now easily talk to each other and share what's happening with your health. These new tools will keep your health record safe and will only be shared with those who you have approved to receive it.

What does it look like for you?

Before your visit, doctors will review the status of your screenings, immunization, and other shared information to discuss any care needs that you might be missing. This helps you stay on top of your health.
During your visit, your primary doctor has your medical history handy and already knows what medications you’re on.
Your doctor can see all of your prescriptions, even those prescribed by other doctors. This means there is less of a chance of being prescribed the same medicine by two different doctors, or that your medicine might not be safe with the other prescriptions you are already taking.
Your doctor won't order scans or screenings that you've recently had completed with another doctor, which can save you money.
After your appointment, an assigned care coordinator will remind you about any follow-up visits and help ensure your screenings or tests are done on time.

Quality-focused care centers around patients. It acknowledges that everyone is different and needs care that’s right for them. You’ll notice a more streamlined experience in and out of hospitals and clinics.

Benefit 3: Get higher-quality care that improves your overall health.

Quality-focused care focuses on the quality of care and its measurable impact on your health. It rewards doctors based on better outcomes for patients. Despite each person’s unique goals, you can still expect overall health improvement in the long term.

What does it look like for you?

If you've just been in the hospital or rehab, quality-focused care means your primary care doctor will closely monitor your condition after you go home. The care team will coordinate to help you get better and stay well.
If you're already in good health, your doctors will focus on keeping it that way. They'll be on the lookout for early signs of illnesses with a focus on preventing issues like diabetes or heart disease.
With preventive care, you're less likely to need emergency room visits or hospital stays, which can save you from bigger, costly issues down the road.
In quality-focused care, your health care team often works with local groups called Community-Based Organizations (CBOs) to offer more learning opportunities and support in your community. This means you get extra help and information close to home.

In the long run, by receiving higher-quality care focused on your personal health goals, you'll also feel more confident and in control of your health journey.

Conclusion

In embracing quality-focused care, or value-based care, we’re stepping into a future where health care becomes a better experience, affordable, and effective. If you're already under programs like Medicare or Medicaid, you might have already enrolled in a value-based care health plan and noticed a positive impact. For those considering joining, a conversation with your doctor is a good start to learn about your current health plan coverage and discuss how you could benefit from quality-focused, or value-based care.

At CareAllies, we're committed to helping doctors succeed in value-based care. With a network of over 6000 trusted doctors and clinicians and a wide range of resources and expertise, we're committed to a care experience that puts your health and happiness at the forefront. Learn more about what we do here.

Your current care experience:	The care experience we need:
Fill out the same forms every time you see a new doctor.	Easy to make appointments and get referred to specialists.
Waiting a lot, but not seeing your doctor enough.	Enough time with your doctor to get all your questions answered.
Getting the same tests or mixed advice from different doctors.	Your doctors talk to each other, know your health history and provide care personalized for you.
Only going to the doctor when something's wrong.	You get regular check-ups to help prevent something from going wrong.
An “assembly line” experience that often ends with a quick fix instead of a long-term plan.	You're more involved in your health choices and have a support team around you.