Value-Based and Accountable Healthcare Models Link Better Outcomes, Increased Revenues

Amid a global health crisis unlike any in memory, healthcare is undergoing new treatments of its own, chief among them the expansion of cost-conscious, value-based care models.

By linking treatments to results — in short, delivering more patient and insurer value for the dollar by improving outcomes — many believe the sector can increase efficacy and lower costs.

Illustrating its role in government health programs, for example, the Centers for Medicare & Medicaid Services (CMS) says, “Value-based programs reward health care providers with incentive payments for the quality of care they give to people with Medicare. These programs are part of our larger quality strategy to reform how health care is delivered and paid for.”

Latest evidence of the trend came Thursday (Feb. 10) with news that value-based healthcare data and analytics platform Signify Health is acquiring Caravan Health, which helps accountable care organizations (ACOs) optimize costs and reach quality improvement goals.

Per an announcement, “Caravan Health will join Signify Health in supporting a wide spectrum of advanced payment models, enabling providers to assume various levels of risk and collaborate in ways that support their goals to improve health outcomes while lowering costs across the care continuum.”

The combined companies will offer medical practices and hospitals analytics and payments solutions to give them better control over costs and payments and manage about $10 billion in medical spend.

See also: Vera Whole Health Closes $370M Deal for Health Data Firm Castlight

ACOs and value-based care are being energized in the wake of a pandemic that exposed affordability and payments issues among patient populations spanning low to high earners in virtually all demographic groups. Recent PYMNTS research confirms the shifting patient/consumer mindset as it relates to treatment outcomes, the cost of those treatments, and how they combine into experience.

According to The Access Channel: How Healthcare Financing Keeps Patients Engaged, a PYMNTS report with research sponsored by CareCredit, “consumers look at healthcare in a holistic way: results matter, but so do customer experiences,” finding that two-thirds of patients are changing healthcare providers “when payments experiences fail to meet their expectations.”

Get the study: The Access Channel: How Healthcare Financing Keeps Patients Engaged

Value-based care models are seen as crucial in upgrading the current system of healthcare payments through insurers, plus out-of-pocket costs and third-party financing options.

However, as healthcare technology news site HIT Consultant reported, “Currently, both payers and providers struggle to efficiently administer value-based arrangements at scale.”

See also: Telehealth, Digital Payments Make Healthcare Easier, Affordable for Patients and Providers