Week 2 discussion response- delivery of healthcare | Management homework help

Week 2 Discussion Response- Delivery of Healthcare Lakenya86Colleague 1 Gabriel Lewis Understanding Value-Based Care Delivery Value-based care (VBC) is a healthcare delivery approach that prioritizes high-quality outcomes, patient experience, and cost efficiency rather than the volume of services delivered. The Walden University (2023) video further emphasizes that value-based care shifts organizations away from volume-focused incentives and toward coordinated care models designed to improve long-term health outcomes. In VBC systems, value is defined as the health outcomes achieved per dollar spent (Porter, as cited in Health Catalyst, 2020). This framework encourages providers to reduce unnecessary utilization, strengthen care coordination, emphasize prevention, and improve population health management (NEJM Catalyst, 2017). As Shi and Singh (2022) note, VBC represents a significant shift in healthcare financing, requiring providers to integrate data analytics, interdisciplinary collaboration, and evidence-based practices to meet established quality benchmarks. Rationale for the Shift from Pay for Performance (P4P) to Value-Based Care The movement away from P4P emerged from its limited ability to meaningfully improve quality. Although P4P offered incentives for specific metrics, it often rewarded isolated activities rather than comprehensive improvements in patient care (Smith, 2020). Providers remained largely within a volume-based environment, and incentives were fragmented across programs. The Centers for Medicare & Medicaid Services (CMS, 2022) emphasized the need for a more integrated model that rewards outcomes rather than processes. VBC was introduced to correct these shortcomings by aligning reimbursement with overall performance, care coordination, and long-term patient outcomes. The shift was also driven by rising national healthcare costs and evidence showing that avoidable hospitalizations, chronic disease complications, and care fragmentation were major contributors to spending (Shi & Singh, 2022). VBC frameworks, including ACOs, bundled payments, and the Hospital Value-Based Purchasing Program, offer financial incentives for improved health outcomes, efficiency, and service integration. How the Shift to Value-Based Care Improved Cost, Quality, and Access

Cost:

VBC encourages providers to reduce unnecessary testing, manage chronic conditions proactively, and prevent avoidable hospitalizations. These efforts help lower overall spending for both patients and health systems (CMS, 2022). Video resources from the American Hospital Association (2018) also emphasize that VBC reduces waste and supports affordability by rewarding efficient care delivery.

Quality:

Value-based programs have improved care quality by linking payment to outcomes such as readmission rates, infection prevention, and chronic disease management. NEJM Catalyst (2017) identifies improved population health, evidence-based care, and better care coordination as core components of VBC. As interdisciplinary teams work more closely, safety and consistency of care improve.

Access:

By expanding preventive care and focusing on equitable outcomes, VBC improves access, especially for underserved populations. Smith (2020) notes that VBC encourages timely preventive services, care navigation, and social needs screening, which help reduce disparities. Additionally, care models such as ACOs and patient-centered medical homes increase access to coordinated primary and specialty care.

Conclusion

Value-based care represents a fundamental transformation of the U.S. healthcare system. By shifting from fragmented, volume-driven P4P approaches to coordinated, outcome-focused delivery models, VBC has strengthened patient outcomes while creating incentives for affordability, quality, and equitable access. As reimbursement continues to evolve, healthcare organizations must expand their capacity for data analytics, interdisciplinary collaboration, and preventive care to fully realize the promise of value-based delivery.

References:

American Hospital Association. (2018, July 25). The value initiative: Framing the issue of affordability & value of health care [Video]. YouTube. https://youtu.be/V7UJEMHzG1sLinks to an external site. Centers for Medicare & Medicaid Services. (2022, March 31). What are the value-based programs?https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/Value-Based-ProgramsLinks to an external site. Health Catalyst. (2020, November 19). Professor Michael Porter – Value-based care [Video]. YouTube. https://www.youtube.com/watch?v=RmXpN_pH3jQLinks to an external site. NEJM Catalyst. (2017, January 1). What is value-based healthcare?https://catalyst.nejm.org/doi/full/10.1056/CAT.17.0558Links to an external site. Shi, L., & Singh, D. A. (2022). Delivering health care in America: A systems approach (8th ed.). Jones & Bartlett Learning. Smith, T. M. (2020, January 10). What is value-based care? These are the key elements. American Medical Association. https://www.ama-assn.org/practice-management/payment-delivery-models/what-value-based-care-these-are-key-elementsLinks to an external site. Walden University, LLC. (2023). What is value-based care? [Video]. Walden University Canvas. Colleague 2 Keona Wilson Explanation of Value-Based Care Value-based care, as I understand it, refers to care delivery, meaning that healthcare providers are compensated not only for patient volume but also for the value of the care they provide. According to the American Medical Association, the “value” should be addressed by the following acronym STEEEP: care should be Safe, Timely, Effective, Efficient, Equitable, and Patient-Centered. (Smith, 2020). Keeping those values in mind encourages providers to focus not only on treating the initial illness but also on supporting the patient's long-term health, prevention, and patient engagement. Shift from Pay-for-Performance to Value-Based Care The primary shift from pay-for-performance to value-based care was driven by concerns about high healthcare costs, fragmented healthcare delivery, and inconsistent outcomes. An article by T.M. Smith highlighted that, under pay-for-performance, financial incentives can reward quantity over quality, furthering inconsistencies that lead to unnecessary procedures, duplicated services, and minimal collaboration between providers. (Smith, 2020). Value-based care aimed to adjust these incentives by rewarding physicians and health systems for how they delivered care through high-quality, cost-effective services that improved patient outcomes. This ensured that everyone is held accountable for population health outcomes and encouraged lawmakers to invest in preventive services and chronic disease management. How the Shift to Value-Based Care Improved Patient Outcomes Overall, the great shift to value-based care offered improvements across cost, quality, and access through data and implementations. In terms of cost, value-based care reduced the amount of wasted resources from unnecessary tests and avoidable hospitalizations. By enabling prevention and coordinated care teams, organizations could lower overall spending while improving quality in the long run. For quality, value-based care encouraged providers to use evidence-based decision-making to address illnesses, continuously measure performance, and collaborate with one another. Keeping those qualities in mind, it will address a few readmissions, have tight control over chronic illnesses, and improve safety outcomes. Finally, value-based care can enhance access by providing equitable support and reducing barriers for high-risk or underserved populations. Since reimbursement is tied to patient outcomes rather than visit volume, providers need to engage more with the patients they serve, who may need more intensive care. There are still challenges, such as measuring value effectively and ensuring data accuracy. In all honesty, the initial movement toward value-based care demonstrates a meaningful effort to build a system that serves patients and supports a more sustainable healthcare system. Overall, value-based care strengthened the need for patient experience, promotes better outcomes, and balances the healthcare delivery structure.

Resources:

Smith, T. (2020, January 10). What is value-based care? These are the key elements. American Medical Association. https://www.ama-assn.org/practice-management/payment-delivery-models/what-value-based-care-these-are-key-elements

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