Healthcare leaders across the US are of the view that the transition to value-based care should happen, however, not many have the answer to the question of how to do it cost-effectively. Healthcare organizations have to innovate and adapt to the new dynamics or else they might risk their long term viability.

The soaring high costs and utilization rates have made it essential for the US healthcare sector to make the transition to value-based care quickly. Value-based remuneration is the only way to incentivize cost-efficient quality care against more volume of services. However, to measure the quality of care, CMS needs providers to report on hundreds of quality metrics. With the advent of EHR technology, physicians are already overwhelmed with the documentation requirements. Now, the additional burden of quality reporting requirements can increase the risk of physician burnout.

From an employer's viewpoint, healthcare costs turn up as the second-largest expense after employee wages. On average, employee absenteeism and poor health cost employers around $530 billion dollars a year. Forestalling these issues requires employers to create efficient benefits package for their employees, and understand their employee health journey at each step.

Struggling with chronic life-limiting illness results in extreme pain, discomfort, and physical as well as mental stress. With no permanent cure available to treat the disease, palliative care can still make a significant difference in enhancing end-of-life care quality by alleviating pain and managing uncomfortable symptoms. 

Every decision in the healthcare segment has high stakes associated with it, not just because a huge amount of money is spent on it, but because people’s lives depend on it. People evaluate all the information available on quality and costs before finalizing providers, payers, and treatment plans, which is giving rise to consumerism in healthcare.

Transitioning and succeeding in value-based care (VBC) is increasingly becoming the focus of many providers. Despite initial reservations, many providers are becoming ardent supporters of VBC payment models and are often the catalysts for change in their organizations.

Innovation has been driving the US healthcare and steering it on the wheels of novel payment models towards better outcomes in quality of care and cost. However, these new payment models seem to be perpetually stuck in a state of delay. 

Imagine your favorite football team is in a real neck-to-neck with another team, and the game could tip in anyone’s favor. It is the last minute, and in an insane turn of events, the quarterback throws the ball in the air, hoping the player in the end zone could make a touchdown. Instead, the reckless throw results in confusion, the guy in the end zone gets tackled, and the game ends in disappointment. 

Once while I was scrolling through the news feed on my phone, there was one specific line that really made me wonder: “There’s a 40% chance of gusty and blustery winds today.” Statements such as this one strongly influence people’s behavior, as they are based on evidence or data findings from years of surveying, studying, and analyzing past trends and occurrences.

ACOs across the states are the flag-bearers of the transformation to value-based care. They toil hard each day to make care more affordable, accessible, and efficient. They are constantly placed under the scrutiny of federal agencies and private payers and are looked upon with aspiration by most patients.