By Healthcare Brew Staff
less than 3 min read
Definition:
Value-based care is one of two models insurers use to determine how much to pay providers. Unlike fee-for-service models, value-based care has different options. These all boil down to payers considering patient outcomes and determining how to give the best end result for the least amount of money.
What are the different types of value-based care models?
Bundled payments provide a set amount of money from an insurer to a health system to cover every provider involved in a procedure, putting the onus of how to divide up the money on the health system.
Similar to bundled payments is capitation, where an insurer pays a set amount to cover an entire group of patients who all have the same disease (rather than covering the procedures themselves).
When did the tide turn in favor of value-based care?
On July 27, 2023, the bipartisan Value in Health Care Act of 2023 was introduced with the goal of incentivizing healthcare organizations to adopt value-based care models. The updated bill builds off the 2021 version and proposes changes to Medicare’s alternative payment models, which are not fee-for-service.
How might health tech factor in?
Recently, numerous health tech companies have emerged to help make value-based care possible. Oftentimes the model falls short due to providers’ insufficient understanding of patient behavior and needs, but this can be remedied with technology. These companies either support health systems as they move into value-based care or focus on specific conditions and develop algorithms to help identify at-risk patients.
