What is Value-based Care?
As per the value-based care delivery model, providers, including hospitals and doctors, are rewarded based on patients’ healthcare outcomes. This approach encourages providers to invest in improving patient health and reducing effects of chronic illnesses in an evidence supplemented way. Furthermore, it derives ‘value’ from evaluating health outcomes against the cost of healthcare delivery. This varies widely from the fee-for-service approach, where providers bill for the amount of healthcare services they deliver.
Quadruple Aim Approach
The value-based healthcare delivery model is in line with the Quadruple Aim Approach developed by The Institute of Healthcare Improvement (IHI). This approach aims to augment and optimize performance of the healthcare sector by yielding improvements in four core areas.
Under this, improved patient experience, lower healthcare costs and better healthcare outcomes are patient-centric outcomes. While improved clinical experience is a provider-centric outcome, it binds the three outcomes together. Without this, the patient-centric outcomes cannot reach full potential.
How to deliver value-based care?
One of the major pitfalls for digital health companies is assuming that a single value proposition would appeal to all, across the board. This, however, is not case. There are multiple stakeholders in the healthcare delivery and each defines value differently. Thur, enterprises must first identify key stakeholders and recognize how each of these derive value. Furthermore, it is essential that you back your value proposition with measurable evidence. Lastly, enterprises need to incorporate varied time-horizons into their Return on Investment (ROI) calculations to better appeal to stakeholders.
Five Key Stakeholders in value-based healthcare delivery
On a broad spectrum, patients value access to care, reduction in out-of-pocket cost and time saving. However, it is critical to understand the patients with chronic conditions will derive value differently than those with acute conditions. Similarly, there are differences in preferences between patients at different life stages.
Thus, digital health companies need to fully understand and empathize with the patients they aim to cater to. Moreover, they need to ensure that the value their solution offers is quantifiable. For instance, if your value proposition is focused on improving access to care, you must measure access to care with and without your product. Doing this will highlight the value of your solution and effectively appeal to the patient.
Payers are companies that pay for an administered medical service and are responsible for processing patient eligibility, enrolment, claims, and payment. These primarily include insurance companies. In the US, the Centers for Medicare and Medicaid Services (CMS) is one of the largest healthcare payers.
Payers value growth and margins. These can be in terms of costs, operational efficiencies, and member satisfaction. Payers are most interested key differentiators offered by digital health companies, given the constant flow of sales representatives trying to showcase their offerings. Therefore, to make their product stand-out, it is essential for enterprises to differentiate, have a good outcome study at hand and be precise in communication.
A provider is a company that administers healthcare services. This can be a hospital or a clinic that provides an in or outpatient medical service or procedure. Like payers, providers are also looking at growth and margins. However, payers most significantly value improvements in patients’ experience and health status, along with timesaving in patient management. Contrary to popular opinion, physicians are keen to adopt new technology, if the offering saves them time, does not complicate processes and solves everyday problems.
These are the employers or organization that offer a group health plan to its employees or members. Plan sponsors are keen to keep health care costs at the minimum, while also ensuring quality care. Thus, they value products and services that help them reduce absenteeism, improve employee satisfaction and retention.
These members of the government derive value from constituent interest and macroeconomics parameters. Policy makers are designated to improve health outcomes, which in turn translate into higher labor productivity.
ROI calculations and the time horizon:
Incorporating relevant time horizons into Return on Investment (ROI) calculations can magnify a company’s digital health offering. This is significant as different stakeholders value different time-horizons. For example, the time horizon for products that prevent diabetes is much longer than products that cure diabetes. While policy makers prefer the extended time horizon for preventing diabetes, payers are more interested in the curative short-term time horizon. Thus, a careful analysis of incorporating relevant time-horizons into ROI calculations that aid digital health enterprises to position themselves effectively.
Thus, for digital health enterprises to adopt the value-based care approach, firstly they need to identify key stakeholders and analyse what they value. Secondly, their value proposition should be measurable. Lastly, ROI calculations need to incorporated multiple time-horizons to better appeal to key stakeholders. By doing so, companies can ensure that they effectively understand their audience and are empathetic to their needs; the key to value-based care approach.
Who are we at LocateMotion?
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Book a demo today to learn more about LocateMotion (SenSights.ai) and how our proactive monitoring solutions can work for you at Sensights.ai/demo
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Contributor: Mariam Javed