Attend any healthcare conference and you’ll quickly discover that it’s become downright fashionable for healthcare leaders to talk about their unwavering commitment to “value-based care.”
The expression has become ubiquitous in healthcare circles. Its virtuousness goes unchallenged.
But should that be the case?
Michael E. Porter and Elizabeth Teisberg (with whom I worked as a student and researcher at Harvard Business School from 2006-2010) popularized the value equation (Value = Quality/Cost) and suggested that improving value should be any healthcare system leader’s highest aim.
Since that time, the federal government has introduced a number of policy instruments to accelerate the transition to value-based care including Medicare Advantage, accountable care organizations, and bundled payment models.
New startups—such as Aledade, Iora Health, Landmark Health, Oak Street Health, and VillageMD—have arisen with the intent of bringing value-based care to the masses.
And big-box retailers such as CVS, Walgreens, and Walmart, too, have jumped on the value bandwagon.
The underlying principle of “value-based care” is simple enough—managing to a lower cost of care for a population of patients, while aiming to improve outcomes.
But what does this value-based care look like in practice in the real-world of patient care (beyond the industry conference jargon and academic expositions on the subject)?
I got the idea for this column after a recent call with a close professor friend who has long been a fan of value-based care. On our call, he expressed dismay at his mother’s care in a value-based medical group that was contracted with her Medicare Advantage plan.
On one occasion, his mother was discharged from a hospital sooner than he felt she should have been (she was later readmitted). On another occasion, she was denied access to a tertiary cancer center, where he believed she should have gone for a second opinion. And on a third occasion, she was denied access to a specialist who my friend felt could have corrected an earlier, botched cataract surgery.
Source: Forbes