There are numerous factors that go into creating quality healthcare. Providers and industry leaders are constantly on the lookout for new and improved ways to measure value. One approach the industry has started adopting is outcome-based healthcare. This is essentially the same thing as value-based healthcare in that it centers around patient outcomes as a baseline for success. In other words, it tracks the success of health providers based on the actual value delivered to patients.
The rationale for implementing value-based care in a healthcare organization is that it can help ensure quality practices and best practices for patients. Industry leaders are looking for ways to justify the rising cost of healthcare, and providing value-based results to the patients they serve is critical to staying competitive in this space.
So, when trying to understand what is value-based healthcare, what is outcome-based healthcare, and what is outcome-based care, it’s important to note that they are all basically the same thing. They are all terms used to describe the model in which the success of healthcare providers is measured in terms of patient care quality. There are often many different features of outcome-based practice, but they all have one goal in mind: to improve the patient experience.
Of course, implementing outcome-based measures can be challenging, especially for organizations that haven’t traditionally operated according to this type of model. MetaCX is here to help get you started. The MetaCX platform aligns suppliers and buyers on expected outcomes and measures value delivery over time, which can be incredibly useful for anyone in the healthcare field.
Understanding Value-Based Care vs. Fee-For-Service
Knowing the proper meaning of the quality outcomes definition is crucial to getting started with outcome-based measures and practices. To answer the question of “what is an outcome-based approach in healthcare,” you must also understand value-based care vs. fee-for-service care. While fee-for-service care rewards providers based on the number of services provided, value-based care incentivizes them based on the actual value of care offered. You can think of this as a quantity (fee-for-service) over quality (value-based) dichotomy.
Needless to say, patients benefit more from the value-based model, as their health outcomes are placed above the almighty dollar. Understanding value-based healthcare vs. fee-for-service care can give you a better idea of the type of model you may want to implement in your own business. More and more health providers are switching to the outcome-based framework, as they are seeing the importance of delivering quality care to the people they serve.
The value-based healthcare 2021 approach and even the value-based healthcare 2020 model put particular emphasis on the patient experience. In recent years it has become increasingly common for healthcare providers to actively listen to the needs of their patients and act accordingly rather than simply focusing on the number of people they see and treat.
The Benefits of Value-Based Care
Value-based care metrics are used to measure the benefits of value-based care and whether or not certain objectives are being met. There are various different pros and cons of value-based care, and it’s important to understand what these are in order to develop a strategy or framework that’s going to work best for your organization and the patients you serve. Outcome-based practice in health and social care legislation can often aid those in the healthcare industry in creating proper outcome measures designed to achieve maximum results.
To further study the impact of value based-healthcare, Harvard has developed a research framework around this approach. Founded on the research of Professor Michael Porter, the value-based healthcare model has been used to restructure healthcare systems around the world with the overarching goal of providing value for patients. Whether you’re examining outcomes management in health and social care, or trying to determine organizational strengths for value-based care that can be applied to your existing business model, it can be helpful to study Professor Porter’s work to gain a more thorough understanding of how and why value-based care matters.
Ultimately, the greatest benefit of value-based care is that it provides quality to patients. While in the past certain healthcare models have focused solely on profit, the value-based approach prioritizes patient needs and strives to deliver the best possible outcomes.
Value-Based Healthcare Challenges
Despite the numerous benefits that value-based healthcare offers patients, there are still downsides to this model that must be considered by those in the industry. Value-based healthcare challenges range from limited internal resources to lack of organizational alignment to difficulty in getting leadership buy-in. Healthcare providers should be aware of the strengths and weaknesses of outcome measures in order to adequately address issues that may arise in the future.
Understanding outcome-based care advantages and disadvantages can also help organizations avoid problems in the first place. There is plenty of criticism of value-based healthcare, and sometimes for good reason. Healthcare leaders should be careful to avoid potential pitfalls and work to spot problems before they develop into a much larger issue.
You might also look to value-based care peer-reviewed articles for insight into the academic side of outcome-based care. Having access to this literature is essential to implementing the right strategies and getting a holistic view of how, ideally, this approach should work.
In addition, MetaCX offers a robust network to healthcare providers that allows them to collaborate with suppliers, employers, payers, and other providers on shared initiatives. MetaCX works to help businesses address some of the common challenges associated with value-based care and get them aligned with others in the industry to achieve positive patient outcomes.
Implementing Outcome Management in Healthcare
Outcome-based healthcare in practice requires that organizations clearly define desired outcomes for certain initiatives, tracking the progress of those outcomes over time. Outcome management in healthcare, then, largely centers around goal-setting and monitoring. Value-based healthcare companies within the value-based NHS are especially conscious of targets and benchmarks as they strive to deliver quality care within a given timeframe.
Really, any sort of outcome-based practice should be aware of how to implement outcome management in theory and in practice. It’s one thing to have a good strategy on paper, and another to apply those strategies successfully in the “real world.” For strategies to implement value-based healthcare, organizations might glean inspiration from what others in the industry have done with their own practices. Outcome-based care planning is tricky, but it can be made easier with the right tools and knowledge.
Under the Health and Social Care Act 2008, outcome-based practice was radically transformed. Among other things, one of the primary aims of this act was to make sure that patients had access to treatment that was personalized specifically for them. It also described the various actions that providers must take to ensure that each patient receives the appropriate person-centered care. A model such as this makes it easier for providers to track and measure outcome-based metrics to determine patient care value.
Choosing a Value-Based Care Model
A value-based care model, or a value-based healthcare framework, revolves around patient care and how well providers can improve patient-centered outcomes based on a series of predetermined metrics. The values of outcome-based practices center around these patient-centered outcomes. There are various different types of value-based care models, so it’s important to understand your organization’s specific needs and goals before implementing any one of these models or frameworks.
There are many different resources about the theories and models of outcome-based practice. The outcomes management model, for instance, tracks patient progress over time in order to assess the effectiveness of different services in delivering desired outcomes.
A good value-based healthcare model will outline the steps necessary to achieve certain goals, as well as strategies for improving existing practices. Theories and models of outcome-based practice vary depending on a number of factors, but most share a common goal: to improve patient outcomes.
Above all, providers should keep in mind the ultimate values of outcome-based practice, which are to deliver quality patient care and to address patient-centered needs in a personalized way. Having a clear goal in mind and following the principles of outcome-based practice can help healthcare providers better serve their patients.
Value-Based Reimbursement Models in Healthcare
What is value-based reimbursement? Value-based reimbursement models in healthcare incentivize providers to deliver quality care to patients. This type of model operates similar to the fee-for-service approach, but instead of being rewarded based on simply the number of people seen, providers are reimbursed based on the value they offer patients. Value-based payment models often pay providers according to a set of outlined objectives for improving patient treatment.
From a patient perspective, value-based care payment models are ideal in many ways. For one, it assures them that they’re getting quality care, but it also ensures that they are treated as individual people with individual needs rather than just another face in the crowd. This is why transitioning from fee-for-service to value-based reimbursement makes sense for healthcare organizations that wish to remain relevant to the patients they serve. As more and more providers adopt outcome-based reimbursement healthcare, learning to be flexible in this way will become critical.
Examples of Outcome Measures in Healthcare
Value-based healthcare can be confusing. Thankfully, there are many examples of outcome measures in healthcare you can turn to for advice and guidance on how to implement this approach in your own work. You can find examples of process measures in healthcare, as well as patient outcome examples, outcome-based approach examples, and other value-based care examples. If possible, look for an outcome-focused care plan template or outcome management in healthcare PPT to help you design a general plan or framework that you can then work to implement in practice.
One outcome-focused care example to consider is an IHS partnering with a pharmaceutical on a set of outcomes. These outcomes might include lowering the cost of care for cancer patients by 20%, reducing readmission rates by improving dosing adherence by 10%, and decreasing PMPM (per member per month) cost within the Type 2 diabetic population by 15%.
MetaCX promotes alignment between health providers and the vendors work with. Additionally, the MetaCX Business Value Network offers resources to help organizations align on expected patient outcomes. Reach out to MetaCX today to learn more about our services and see how we can help your organization implement outcome measures in your healthcare practices.