A simple and bold idea of improving healthcare for patients is value-based care. Value-based care is supposed to improve healthcare results and to reduce care costs by focusing on overall wellness of the population and preventive treatments.

Value-based care is simply the idea of better quality care at a lower cost with better results for patients. A set of changes is necessary in the way people receive care to reach the goal of higher quality. Healthcare delivery should become proactive instead of reactive, controlling, delaying and preventing problems before they start, and become creative and come up with better solutions to difficult problems. Attention should be made to all the factors that contribute to the health problem not just the disease itself, psychosocial factors, financial factors and affordability, and environmental factors all play a role in better results. Overall general wellness, healthcare quality, and preventive screenings become key in leading to better healthcare outcomes at a lower cost for the system.

What changes for me as a patient with value-based care?

None of your doctors, dialysis units or care providers change. In value-based care, bright minds are put together, best practices are applied to standardize healthcare processes like any good business. Historical evidence and data analysis can determine which treatments and processes work and which ones don’t. Best treatment results for patients are achieved by this analysis which creates best workflows and care pathways for different conditions.

Value-based care emphasizes wellness and prevention. Prevention of disease progression (through dietary changes, lifestyle changes, healthy habits, weight loss, exercise and guideline directed medical therapies) not only reduces hospitalizations in the future but also the need for costly procedures, unnecessary tests, and unneeded ailments and treatments.

Keeping a group healthy cuts healthcare costs for everyone. For example, value-based care can help you avoid complications of a chronic condition like CKD or Chronic Kidney Disease. A specialized integrated kidney care team that already knows you and your health background helps reduce complications and delay progression of your underlying condition. Instead of getting fragmented care, you work with a team, which may consist of your nephrologist, supporting nurse practitioners, healthcare professionals and nutritionists, to help you:

• Keep your kidney function stable and blood pressure under control.
• Stay on a healthy diet.
• Sign up for a kidney transplant.
• Set up realistic goals and exercise program.
• Deal with the emotional and psychological aspects of kidney disease.

How does value-based care reduce costs?

With implementation of value-based care, doctors and hospitals get paid based on quality of care and outcomes, not on numbers of encounters, procedures done, or how much they are charged. Payments are bundled like dialysis monthly capitation instead of charging a patient for each individual test or service. This is important especially in patients with more complex problems like CKD, diabetes and heart failure.

Shared information among electronic medical records for each patient reduces costs by eliminating repetitive and unnecessary tests and procedures. Efficiency improves, less time is wasted, healthcare navigation becomes easier by using care coordinators among teams of physicians and healthcare professionals. Communication improves and patients move through this integrated kidney care environment more effectively.

An ultimate long-term goal of value-based care is a healthier population with less frequent hospitalizations, trips to the emergency room, and less readmissions. It’s a bold idea to keep healthcare costs under check, produce better healthcare results and most importantly, improve overall well being and health of patients.