Why should we make the transition to Value Base Care?  The focus of this paper will be to discuss and evaluate the Value Base Care. The time for change is now! What are some of the benefits to change from a Fees for Service to Value Base Care?

What is Value Base Care

Value  Base Care is helping to improving the quality of care for patients. The health care team have to create a plan geared toward each patient needs. Value Base care is changing the way services is being providing from reactive approach to a proactive approach.

History

According to the World’s Meter the global population is around 7.7 billion people in January 2019. As of January 25, 2019, healthcare spending is 18.2 percent of the Gross Domestic Product.   Over the next six years the Gross Domestic Product spending in the US healthcare spending will increase by an average of 5.8%. (Value Based Healthcare, pg3 par.1,)

What is Fee for Service

Fee for service reimburse doctors and hospitals base on the number of patients that are serviced. The doctors and hospital receive incentivizes for the number of tests that are order for the patients. The provider and or hospital is paid for the service no matter the outcome.    The payment system is set up to reward volume and not value.  (Miller, 2009 pg.1 par.1)

History

Value-base care provides health care patients with quality care. The Centers for Medicare & Medicaid Services (CMS) defines value-based care as those programs that “reward health care providers with incentive payments for the quality of care they give to people with Medicare .” CMS began emphasizing value-based, quality healthcare over the quantity of provider visits in 2008.  (Peirce, 2018)

The Transition

The transition to Value-Base care means better quality care. The Centers for Medicare & Medicaid services  (CMS) have set targets for purchasing requirements on payers. The targets are link to reimbursement base on improvements in safety indicators, and patients out comes. Provides have to understand the Value -Base objectives is to improve the quality of patients care. By improving effectiveness at the begin when a person walk-in for service until the last step when the bill is mailed out.

Advantages

The Value-base care will give bonuses for providers being accountability for performance. The US Health care system will have greater access to quality care. Hospitals and provides will measure quality and financial performance and for each patient. Doctor’s that are using electric medical recorders will have more accurate information to assets the patient needs.

Disadvantages

A risk for Value-Based Care is when the hospital or medical center preform below expectation or the standard they won’t receive the incentive.  A hospital that has high readmission rates will be pay a financial penalty. (Brown, 2014) Hospital are required to track 30-day readmission now they will be required to track 90-day readmission rates. (Brown, 2014)  Medical has added three more items to track for readmission heart attack, heart failure, and pneumonia. (Brown, 2014)

Staffing Challenges

The Healthcare industry have a hard time finding and retaining physicians and nurses. The transitions to value base care hospitals need information technology personnel on staff. Hospital and medical centers have to find creative ways to handle the shortage of staff.   To retain physicians and nurse’s healthcare centers should consider sharing the profit percentage. (Madhan, 2017)

Volume to Value

I understand that it is easier said than done. The transition from volume to value is  going to take time. Currently both payment systems are being used. The goal is eventually to switch to the value payment system.  We have to give hospitals and medical centers time to adapt to the new deliver system. “ At first, hospitals may struggle to align the financial incentives because doing so will require adopting new skills to limit bed days and procedure volume”    (Burns, 2013 par. 8)

 
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