Value-Based Care as Integrated Care

There is a lot of talk in the healthcare world lately about “value-based care.” This means that instead of being paid for each individual test, procedure, or office visit, health care providers are increasingly being reimbursed based on how well they improve patient outcomes. In other words, providers are being paid to keep people healthy, rather t... See more

Those are promising signs. On the other hand, the fundamental economics of the value-based arrangement still aren’t clear. If fee-for-service turns out to more profitable for both payer and provider, then value-based care won’t survive outside of Medicare Advantage. And there have been failures in the past, as cited above.

Under value-based care, payers win financially when their members are engaged and receiving the right care, because that’s how they both drive membership AND limit costs. Patients are the winners.