Four strategies to advance value-based care – American Alliance for Dental Insurance Quality

Amid rapid health care industry consolidation, a challenging cost environment, and increasing patient needs and expectations, only truly nimble health care organizations will survive and thrive.

Medical groups focused on prepaid, value-based care are better positioned to innovate, develop, and invest in technologies to respond to patient needs and market dynamics. For example, value-based organizations that bet big on telehealth and remote patient monitoring technologies prior to 2019 were able to continue seeing patients remotely during the COVID-19 pandemic. In contrast, fee-for-service health care systems — which are paid per office visit, treatment, and test — struggled. As a result, a movement is now underway in health care, from volume of care to value of care.

Shifting to value-based care

Value-based care organizations prioritize prevention through early detection and proactive treatment of health issues. Physicians and care teams work together to manage the overall health of individuals and populations. Financial incentives are tied to keeping the patients and communities they serve healthy. Every interaction, from telehealth, including video visits, to in-person visits, is an opportunity to address patient needs, including access to healthy foods and community-based resources. The guiding principle is evidence-based, quality care that is cost-efficient while maintaining convenience and affordability to patients.

Last year, the U.S. Centers for Medicare & Medicaid Innovation issued an ambitious goal to shift 100% of Medicare beneficiaries into an accountable care insurance plan by 2030. Given that the number of Americans 65 years and older is projected to increase more than 40% to 82 million by 2050, that announcement signals a massive shift in strategy where a huge swath of Americans will receive some form of health care services tied to value arrangements.