How value-based care will change healthcare

Although the transition to value-based healthcare may be difficult, the end result of reduced costs and improved care and patient outcomes will be worth it, according to the president and CEO of the Cleveland Clinic.

Toby Cosgrove, M.D., in a blog post for the Harvard Business Review, described value-based healthcare as a "breakthrough that will change the face of medicine." He said the pay-for-performance model will lower healthcare costs, improve quality and outcomes and eventually affect every patient across the United States. But the road ahead is difficult, he said, as many oppose the plan, which offers less money than the current fee-for-service model.

"Whether providers like it or not, healthcare is evolving from a proficiency-based art to a data-driven science, from freelance physicians to hospital-employed physicians, from one-size-fits-all community hospitals to vast hospital networks organized around centers of excellence," Cosgrove wrote. "Each step in this process leads to another."

Because value-based care will necessarily involve making less money for better outcomes, Cosgrove wrote it is being delayed by "criticism, misunderstanding, and a reluctance to do things differently." But, he said, providers should view it as an opportunity rather than a problem. "After all, the providers who make the transition early will be rewarded with more satisfied patients, lower expenses, and pride in a job well done."

However, not everyone agrees with Cosgrove on the feasibility of value-based care. The uniqueness of each individual patient complicates the idea of "mak[ing] all of medicine measurable and quantifiable," David A. Shaywitz, M.D., Ph.D., director of strategic and commercial planning at a San Francisco-based pharmaceutical company, wrote in The Atlantic.

Patients' medical conditions tend not to be homogeneous, and a small portion of patients who may have complex, overlapping conditions are responsible for the majority of healthcare costs, Shaywitz wrote.

For a value-based compensation system to be effective, he said, providers must "embrace the messiness of disease and the complexity of patients."

Meanwhile, a 2012 study in the New England Journal of Medicine found incentivized hospital care had negligible effects on 30-day mortality rates. A four-year study of New York City hospitals similarly showed the model reduced costs but did little for patient outcomes, FierceHealthcare previously reported.

To learn more:
- here's Cosgrove's blog post
- check out Shaywitz's article

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