5 Foundational Capabilities Needed for Implementing a Value-Based Care Program

5 Foundational Capabilities Needed for Implementing a Value-Based Care Program

Healthcare providers and practices face significant challenges in the United States, where despite the highest healthcare spending globally, patient outcomes lag behind other high-income nations. Value-Based Care (VBC) aims to address this by rewarding providers for delivering measurable, cost-effective health outcomes. Embracing VBC offers opportunities to enhance patient well-being while protecting practice profits in a stagnant fee-for-service environment. CMS.gov data reveals physician and clinical service expenditures at 5.6% in 2021, with VBC spending growing at a 15% annual rate. However, barriers to entry include evolving regulations, resource constraints, revenue unpredictability, and limited healthcare data access. Practices must navigate these challenges by supporting fee-for-service while participating in VBC programs, necessitating the development of essential capabilities to thrive in this evolving payment landscape. These foundational capabilities will empower practices to excel across the value-based care spectrum as reimbursement trends shift.

Medigy Insights

Healthcare providers and practices in the United States confront formidable hurdles despite leading global healthcare expenditures. Patient outcomes remain inferior to those in other affluent nations. Value-Based Care (VBC) emerges as a solution, incentivizing providers for cost-effective, measurable health outcomes. VBC adoption fosters patient well-being and safeguards practice profits within a stagnant fee-for-service milieu. CMS.gov data reports 5.6% spending on physician and clinical services in 2021, with VBC expenditure growing at 15% annually. Nevertheless, entry barriers persist, including evolving regulations, resource constraints, revenue instability, and limited healthcare data access.


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