Value-based health care measures success not by how many services are given but by how much patients improve for each dollar spent. Elizabeth Teisberg, PhD, calls value “the measured improvement in a person’s health outcomes for the cost of achieving that improvement.” This is different from older models that mainly focus on following rules or cutting costs without linking to patient results.
It can be hard to put value-based care in place. Doctors and staff might resist change, tracking health results accurately is tough, and different groups need to work toward the same goals. But when done right, value-based care helps patients do important activities better, feel less pain, and live more normal lives during treatment. These ideas come from frameworks made by Teisberg and her team.
A key part of good value-based care is using interdisciplinary teams. The National Academy of Medicine says these teams have at least two health providers who work with patients and caregivers toward shared health goals. Unlike teams that work separately, interdisciplinary teams share knowledge, talk often, and make care plans together.
These teams often include doctors, nurses, social workers, behavioral health experts, community health workers, chaplains, and others. They help with both medical and social or emotional patient needs. This mix makes it easier to handle complex situations.
Studies from many health systems show these teams help patients and lower costs:
The National Academy of Medicine says these teams work best when they follow five rules:
When teams use these rules, patient safety improves, mistakes go down, problems fall, and patients feel better cared for through teamwork.
Patient experience is an important way to measure quality in healthcare. It affects how well patients follow their care plans and what results they get. Studies show when patients think their care team is organized and communicates well, they are much more satisfied. For example, 72% of patients at Montefiore Health System felt closer to their care team because of team-based care and app-driven case management.
By including patients and their families as part of the care team, providers can better fit care to each person’s social, medical, and emotional needs. This makes care plans effective and suitable for each person’s life situation and choices.
Training doctors and other health workers is important to make sure they can work well in value-based care. Dell Medical School at the University of Texas at Austin teaches value-based care ideas throughout its four-year program. Students watch and join care teams working with patients who share needs, like chronic joint pain. This helps students learn how to measure results and work well in teams.
Hospitals around the US have also started teamwork training programs like TeamSTEPPS. These teach better communication, leadership, and paying attention to situations. Training helps break old hierarchical habits and supports teamwork needed for good interdisciplinary work.
Value-based care looks at the whole person, not just symptoms. Social determinants of health, like transportation, food security, housing, and education, affect health results and costs.
Interdisciplinary teams often include or work with social workers, community health workers, and other groups that help with these social factors. Nurse-led care models show promise for helping Medicaid patients with both physical and mental health needs. However, some rules limit what nurses can do, which lowers the impact of these models.
Medicaid reforms that support nurse-led and team-based care fit well with value-based care goals. They work to improve health results and keep costs down by treating the whole person.
Healthcare is complex, and technology helps interdisciplinary teams work better. AI tools can automate simple tasks. This saves time, lowers paperwork, and lets doctors focus more on patients.
For example, AI phone systems can handle scheduling, reminders, and answering questions any time of day without getting tired. These systems also cut wait times and make patients happier.
Automation helps clinical teams talk with each other, especially when many providers need to work together. AI tools can connect with electronic health records and care platforms. This gives team members timely information and alerts to help them make good decisions.
In places like Texas, where many healthcare providers use AI, AI phone services are important for handling lots of patients. These tools make communication smoother and keep care running well. AI also helps measure individual patient results and costs, which is needed to track progress in value-based care. This helps teams learn where they need to improve and use resources wisely.
Leaders in medical practices need to know what it takes to improve value-based care outcomes:
As value-based care grows in the U.S., especially in big markets like Texas, interdisciplinary teams supported by AI and automation can help medical practices improve patient results while managing costs.
By learning from leading health systems and schools, medical practice leaders and IT staff can build systems and use technologies that support value-based care goals. Interdisciplinary teams combined with education and AI tools offer a clear way to improve health outcomes, patient satisfaction, and keep costs under control.
Value-based health care focuses on the measured improvement in a patient’s health outcomes in relation to the costs incurred to achieve that improvement. It aims to create more value for patients, prioritizing health outcomes over mere cost reduction.
Texas has seen significant adoption of AI medical answering services due to its large healthcare market, making it a pivotal area for innovation and integration of technology in health care, particularly for improving patient interactions.
Challenges include resistance to change among clinicians and organizations, the need for accurate health outcome measurement, and the complexities of aligning diverse stakeholders’ objectives in a value-based framework.
Health outcomes are described in terms of capability, comfort, and calm, focusing on the patient’s ability to function, relief from suffering, and normalcy during care, which collectively improve patient experiences.
Interdisciplinary teams are critical as they can design and deliver comprehensive solutions tailored to specific patient needs, integrate services, and foster communication, thereby improving efficiency and health outcomes.
Measurement of health outcomes and costs is essential for assessing the effectiveness of care. It enables teams to understand their performance, identify improvement areas, and align incentives to enhance patient care.
Segmenting patients based on shared health needs allows clinical teams to organize services effectively, anticipate needs, and provide tailored, efficient care that leads to better health outcomes.
Incorporating value-based care principles into medical education, as shown in Texas’ Dell Medical School, equips future physicians with the skills to implement and lead transformative care delivery models.
By improving health outcomes, value-based care minimizes disease progression and the need for extensive ongoing care, resulting in lower overall healthcare costs in the long term.
As care teams demonstrate positive outcomes and efficiencies, there is an opportunity for expanded partnerships with employers and other healthcare organizations, aligning several stakeholders towards high-value care objectives.
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