Value Based Care — A Model For The Medical
Tourism Industry
Medical providers in the United States have traditionally operated on a fee-for-service model.
Under this model, insurers reimburse healthcare organizations for services rendered
regardless of the outcome. But a new approach, value-based care, is gaining steam.
Value-based care links reimbursements to patient outcomes, incentivizing providers to
prioritize the patient’s short and long-term health goals, as opposed to performative
management style which emphasizes procedures.
The goal of value-based care is twofold: eliminate unnecessary spending and improve
patient outcomes.
Phasing Out an Old Business Model
Fee-for-service has long been the model for healthcare operations in the United States. The
problem with fee-for-service is that it rewards procedures rather than outcomes. Hospitals
and other providers charge based on the number of beds filled, tests ordered, and
treatments performed. The more a provider does, the greater their profit.
It’s easy to see how this model may incentivize hospitals to order high tech, extensive, and
invasive testing or treatments that are unnecessary or do not lead to better outcomes.
But in healthcare, preventative, less invasive, or lower cost procedures are sometimes the
best solutions for addressing and managing a patient’s problem list. And in general, if a
patient is healthy then fewer tests, treatments, or overnight stays are necessary. To
incentivize healthcare providers to maintain efficient operations and high quality care, a shift
in billing practices may be needed. This is a core principle of value-based care.
Benefits of Value-Based Care
With value-based care, reimbursements are tied to patient outcomes and the quality of care,
thereby rewarding providers based on effectiveness and efficiency. Providers are
incentivized to focus on preventative care and education in order to minimize post-treatment
complications and rates of hospital re-admittance, and improve managed care for those with
chronic conditions.
Affordability is Incentivized
Value-based care rewards providers for doing more while spending less. Although start-up
costs for installing systems such as digital health programs may be high, by offering patients
low-cost access to care, these care models are cost-effective in the long run. Additionally,
patients are more likely to seek care when needed as a result of its affordability.
Communication Improves
Sharing information between providers and facilities creates better outcomes for patients. In
a reimbursement model, healthcare providers are pitted against one another as competitors.
But value-based care incentivizes teamwork amongst all involved providers caring for a
patient. Patients benefit from stronger, more connected health networks.
Administrative Waste is Minimized
Improved communication and shared information not only benefits the patient but reduces
administrative waste. Bundling payments across departments or even providers requires
less administrative detail and allows for more equitable sharing of resources.
Quality of Care Increases
Because patient satisfaction is the gauge by which successful delivery of care is measured,
providers are encouraged to do all they can to receive positive reviews. Clinical care
research suggests that doctors and nurses who work in environments where patients are
prioritized over procedures are less likely to become burned out. Employee retention
benefits everyone.
The results of implementing this method of care is a shared experience that is valued and
appreciated by the patient, provider, and insurer, while facilitating quality, concierge-level support
for domestic and international medical tourists.
Source URl:https://medium.com/@selenaparker011/value-based-care-a-model-for-the-medical-to
urism-industry-9e8bd2c8591c