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Breaking Down 3 Myths About Value-Based Care

How much do you know about value-based care? Even informed people sometimes carry health care misconceptions about alternative payment models, especially when they’re complex.

Here’s a look at three common myths about value-based care and why they just don’t hold water.

Myth 1: Value-Based Models End Up Costing More

Health care is already expensive, and it’s understandable to worry about having to shell out even more cash to stay in good health. However, there’s a wealth of data demonstrating how value-based care actually lowers health care costs while prioritizing quality care.

The return on investment comes from the combination of reduced costs — for employers and employees alike — and improvements in care quality. It all works toward ensuring a healthier workforce, which lowers medical costs. It also spells increased productivity, plus reduced absenteeism and presenteeism. All of those factors can add up to significant savings.

So why are some employers still hesitant? This myth still has traction for two reasons: First, many employers believe that better benefits cost more. In the past, that’s often been the case. But it all depends on the plan design. In short, strategically improving benefits lowers costs. Second, the savings aren’t necessarily immediate. Employers may face some initial upfront expenses in exchange for savings later on — understanding the return on investment requires looking at the long term, not the next payment.

Nevertheless, it’s an easy myth to bust. Examples abound:

  • Value-based Blue plans nationally reported a 10 percent drop in ER visits, a 2 percent decline in hospital stays and an increase in prevention and chronic care management.

Value-based arrangements get to the heart of what drives up health costs — hospital stays, ER visits, over-treatment and pricy chronic conditions included. This is what bends the cost curve. Don’t fall for health care misconceptions that suggest otherwise.

Myth 2: Patient Satisfaction and Experience Are the Same

Improving patient experience is an essential element of value-based care, so it’s important to clear up this myth. Patient satisfaction is not the same as patient experience.

Customer satisfaction is critical to any business. But as you probably know, consumers often rank their satisfaction based on personal factors. In health care, that could be anything from wait time to a successful outcome — and unfortunately, doctors sometimes have no choice but to deliver dissatisfying news.

Patient experience goes deeper. It addresses issues like patient-clinician communication and how deeply care providers understand a treatment plan. This actually isn’t just a value-based care myth — it’s a one of several common health care misconceptions.

The Agency for Healthcare Quality and Research (AHQR) puts it well. The AHQR says that evaluating patient experience means learning from patients to find out “whether something that should happen in a health care setting (such as clear communication with a provider) actually happened or how often it happened.” By contrast, a patient’s satisfaction describes whether their personal expectations were met. The result, according to the AHQR, is that “[t]wo people who receive the exact same care, but who have different expectations for how that care is supposed to be delivered, can give different satisfaction ratings because of their different expectations.”

The bottom line? A good patient experience often correlates with better care.

Myth 3: Value-Based Care Only Works for Large Companies

Value-based plans aren’t limited to the biggest of the big. Yes, Fortune 500 companies get the most attention when they successfully implement value-based initiatives. What you don’t hear as often are the smaller success stories — but they’re happening every day in companies of all sizes across the nation.

Here’s the truth: Value-driven plans work just as well with 100 employees as they do for companies with 10,000. Insurers are working directly with small and mid-sized businesses to provide value-based plans. Don’t let common health care misconceptions keep you from improving employee health and lowering costs.

One final tip: The term “value-based care” covers a lot of territory. Employers, especially small and midsize ones, have the best chance for successfully lowering the total cost of care and improving patient outcomes by working with a partner with expertise in the area.