VOLUME BASED TO VALUE BASED CARE 4
For over 50 years now, the U.S. healthcare system has operated onthe volume-based reimbursement system where the providers are paidfor the quantity of services they offer to the patients. In otherwords, the health providers are paid for number of surgeries theconduct or the number of patients they attend to. However, thissystem is quickly changing and the U.S. healthcare system istransitioning to the value-based reimbursement system (Porter &Teisberg, 2014). This is a model that focuses on the results ofhealthcare services. It is mainly interested in the quality of carethat the providers give the patients. Aspects such as readmissions,development of complications from operations and hospital-relatedinfections are considered in this system. Stakeholders in thehealthcare system have asserted that the system will greatly improvethe quality of care delivered to the patients and payers will pay forquality services that have positive outcomes for the patients.
Thesis: Although the volume-based system has been operational forover five decades, it is evident that it has led to low quality careand it is essential to move to the new value-based model.
This transition has had tremendous effects on the healthcare system.This is primarily because the operations at the healthcare centersmust be changed to accommodate the principles of the new model. Theproviders will have a great responsibility of collecting andcompiling data in order to measure the quality of care beingprovided. Further, the providers will have to grapple with thereduction of costs (Porter & Teisberg, 2014). This means that thenumber of staff might need a reduction. Considering that this is aparadigm shift of an entire system, it is evident that theoperational strategies of providers will need to be aligned with themodel. In other words, the volume-based system will have to be inprogress while principles of the new model are being implemented.
Healthcare providers, in collaboration with the payers must developbudgets that are aligned to the provision of quality care. Sincepatients are at the center of this new model, it is essential forhealthcare providers to enhance their communication and follow-upwith patients (Shah, 2015). It is equally essential to providepatients with their progress reports and the expected reports oftheir treatment plans.
The transition from volume to value based care will take aconsiderable amount of time. This is because it is a completeoverhaul of a system that has been in existence for over 50 years.Healthcare providers must reduce the cost and improve the quality ofservices. The value-based model will ensure that the patients receivequality care.
Porter, M. E., & Teisberg, E. O. (2014). Redefininghealth care: Creating value-based competition onresults. Boston: Harvard Business Press.
Shah, N. (2015). Understanding value-based healthcare.New York: McGraw-Hill.