Maureen Bonatch

3 Ways Value-Based Care Helps Improve Outcomes for Chronic Conditions

Statistically, it’s likely that you have employees living with chronic conditions. In fact, 6 in 10 Americans has one.

When your employees have heightened care needs, they don’t care about the number of tests the lab technician ran — they just want to feel confident that they’re going to feel better.
Value-based care reflects this by paying providers for the quality — not quantity — of the services they offer.

By focusing on outcomes through holistic, patient-centered care, a value-based care system can help improve the health of your employees living with chronic conditions. Here are three reasons why.

Care Coordination

The financial incentives that come with paying providers for the number of services they provide over the outcome of those services can fragment patient care. In contrast, value-based care establishes incentives for doctors to work together to share information and coordinate the care they deliver for the best possible outcome. Coordination — through data sharing among providers and encouraging patients to become more involved in their care — can help doctors pool their resources to identify and treat health concerns that might otherwise go unnoticed. The primary care physician may seek guidance from a specialist through an electronic consultation (or e-consult), potentially expediting care, though the patient may still follow up with a separate visit, since specialists may take the lead for some chronic medical conditions as their role evolves with specialty-specific bundled payments.

Coordinating care can help most patients, but those with chronic diseases like diabetes could see the greatest benefit. Unlike with many other chronic health conditions, patients with diabetes often manage their own care for decades. Care coordinators can provide education on living with diabetes and managing symptoms to maintain their quality of life. In the “Glucose to Goal” study, which evaluated the impact of diabetes educators in a value-based care model, 80 percent of participating patients improved their blood sugar levels.

Health Information Technology

According to the Centers for Disease Control and Prevention, someone has a heart attack every 40 seconds in the United States. Heart disease is the leading cause of death in both men and women across most racial and ethnic groups, so almost any of your employees could be at risk for this chronic condition. High blood pressure, which increases the risk of heart disease, can be managed — but only by actively involving the patient in solutions that work with their lifestyle.

When patients take part in a value-based care system, research says they adhere better to medication and condition-management plans. This is doubly true when they’re given the tools to play a leading role in their own health. Telemedicine, apps and wearable devices all offer patients the opportunity to comply with treatment without disrupting their lives. When providers make it easy for their patients to be proactive about their health, they will be.

Preventive Screenings

There are more than 100 types of cancer. The earlier it’s caught, the easier it generally is to treat — and vaccines for some conditions, including HPV and Hepatitis B, can help to reduce the risk for certain kinds of cancer. Value-based care’s emphasis on supporting well-being through prevention could be why patients within a value-based care model receive 10 percent more cancer screenings. A focus on prevention — in tandem with greater patient engagement and education on health options — can help your employees make informed decisions about their care and determine the treatment they’d prefer to receive.

Under the fee-for-service care model, providers sometimes overutilize tests and treatments for patients with cancer. The shift in focus toward quality of life and outcomes may help reduce unnecessary ER visits and tests while increasing the use of palliative and hospice care. All of these individual pieces are the building blocks of a better patient experience — when patients are active participants in their care, they can more easily follow a care plan and reach their unique health goals, whether they want to manage a condition or alleviate pain.

Your business depends on a present and productive workforce. Without proper treatment and strong health plan options, chronic conditions can lead to a rise in workplace absenteeism, decreased quality of life and higher health care costs for both you and your employees. The value-based care and fee-for-service models both developed to support better health. They just have different ways of making it happen — and different levels of success. Value-based care takes an informed and patient-centric approach to care so patients can decide what high-quality care means to them and work with doctors to achieve it. When chronic conditions set up residence in the workplace, value-based care rewards providers for keeping employees healthy.