Value-Based Care May Fund Our Field No Better Than a Fee-For-Service Model

Value-Based Care May Fund Our Field No Better Than a Fee-For-Service Model

Plans for value-based care (VBC) to replace fee-for-service care are still largely unrealized. Progress has been especially slow in behavioral healthcare, but enthusiasm remains strong. This may relate more to disdain for the status quo than any evidence VBC will improve our healthcare funding. There are no guarantees of adequate funding for behavioral care in the VBC model. VBC broadly entails healthcare providers assuming financial risk while earning incentives for outcomes. The challenge of fitting outpatient care into VBC contracts starts with the risk-bearing entity. Multiple specialties may be funded by the VBC payer, with behavioral care as one piece of the puzzle. Health systems (or VBC payers) may or may not want a robust behavioral network. 

Medigy Insights

The implementation of value-based care (VBC) to replace fee-for-service models has been limited, especially in behavioral healthcare, despite strong enthusiasm. The slow progress may be driven more by dissatisfaction with the current system than evidence of improved healthcare funding. Funding for behavioral care in the VBC model is uncertain, as VBC contracts often include multiple specialties, making it challenging to prioritize robust behavioral networks. Integrating outpatient care within VBC contracts presents additional challenges, including identifying the entity responsible for assuming financial risk. Addressing these concerns and ensuring dedicated funding are crucial for the success of VBC in improving healthcare outcomes.


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