What is value-based care?

By Michelle Magnus  

Healthcare has evolved greatly over the years, and one of the biggest shifts has been from a fee-for-service model to a value-based care model. Here we’ll discuss this shift, why it matters, and how it’s changing the face of healthcare for the better. 

The shift to value-based care 
While there are several healthcare models, historically healthcare has commonly used a fee-for-service model. This meant that healthcare providers received service-based compensation for the number of procedures performed, rewarding providers for volume and quantity of services. The problem: Outcomes weren’t considered. 

In recent years, there’s been a reimagination of healthcare, shifting to a model that focuses more on quality and less on quantity. This is what we call a value-based care model. 

So, what is a value-based care model?  
A value-based care model focuses on delivering high-quality care that produces positive outcomes.  

In 2007, the Institute for Healthcare Improvement identified the aims of healthcare, which became the driving goals for value-based care. The key areas of focus included:  

  • improving the health of populations 
  • providing better care for individuals 
  • lowering healthcare costs  

More recently, value-based care has expanded to include two additional areas of focus: clinician well-being and health equity.  

Clinician well-being, added in 2014, recognizes the importance of reducing administrative burdens and providing clinicians with the necessary tools to prevent burnout. And health equity, added in 2021, aims to ensure that everyone, regardless of their background, has equal access to high-quality care. 

Why does value-based care matter for healthcare? 
In 2021, per person spending in the United States was nearly two times higher than in Germany and four times higher than in South Korea. While the United States has consistently spent more on healthcare than other countries, this hasn’t translated into better outcomes. A value-based care model can help reduce these costs.  

And it’s not just a financial benefit, value-based care can also help reduce preventable deaths by providing timely and effective interventions along with provider accountability. In 2017, the U.S. had more treatable deaths per 100,0000 people than any other comparable country. 

Embracing value-based care has the potential to transform healthcare by empowering patients and ensuring that high-quality care is accessible, affordable, and tailored to individual needs.