How Does Value-Based Care Impact Patient Outcomes?

The transition from fee-for-service models to a value-based care model in healthcare has been a difficult but important progression, especially for independent practices. And it’s not going away anytime soon — The Centers for Medicare & Medicaid Services (CMS) project that by 2030, 100% of Original Medicare beneficiaries will be under accountable care relationships.

But will a transition to VBC actually have an impact on the most important metric in healthcare: patient outcomes?

In this article, we'll explore whether value-based care models are actually improving quality of care and patient health, or if the traditional fee-for-service approach still holds merit.

Value-Based Care vs. Fee-for-Service in Cardiology

Though cardiology has traditionally preferred fee-for-service as the dominant payment model, there is data to suggest that a transition to VBC can positively impact patient outcomes.

A 2022 study published in JAMA Network Open highlighted the quality and efficiency of Medicare Advantage (2-sided risk) compared to FFS. The analysis, which included a diverse set of 316,312 individuals across various age groups, revealed that MA outperformed FFS in eight key areas.

Across the board, MA patients saw significantly lower rates of inpatient admissions (18% lower) and emergency department visits (11% lower). Patients in MA also experienced a 9% lower rate of 30-day inpatient readmissions.

Moreover, MA patients experience a 10% reduction in admissions for stroke or myocardial infarction and a 44% decrease in hospitalizations for COPD or asthma exacerbation.

A 2023 Humana report also confirms that VBC patients generally experience lower hospital admission rates, with 30.1% fewer in-patient admissions compared to those under Original Medicare.

These results indicate that the value-based care models not only deliver higher quality care but also decrease healthcare costs associated with hospitalizations.

Why Does Value-Based Care Lead to Better Outcomes?

In general, the transition to value-based care represents a shift in healthcare to prioritizing patient health outcomes over service volume. In its report, Humana also found that VBC patients received preventive screenings at an increase of 14.6%.. These preventative screenings can have a significant impact on patient outcomes, especially in specialties like cardiology where early interventions to address modifiable risk factors are so vital.

Here are a few of the key qualities of VBC that support better patient outcomes:

• Aligned Incentives: Providers are financially motivated to improve patient health rather than increase the volume of services.
• Proactive Management: A larger focus on prevention and chronic disease management reduces complications and hospital readmissions.
• Patient-Centered Approach: More time spent with patients leads to an increase in patient satisfaction, education, and overall outcomes.
• Cost Efficiency: Potential cost savings are reinvested into patient care improvements.

When healthcare systems are reimbursed based on care quality rather than the quantity of services provided, all stakeholders benefit.

The Limitations of Value-Based Care

While value-based care (VBC) offers significant benefits for patient outcomes, its success hinges on healthcare providers having access to necessary tools and resources. Transitioning to VBC can come with several added challenges, such as:

• New Compliance Considerations: Providers must navigate a changing landscape of regulatory requirements on local, state, and federal levels.
• Coding Requirements: Accurate and comprehensive coding is essential for appropriate reimbursement and tracking of patient outcomes.
• Administrative Burden: Increased administrative tasks can strain resources and staff, potentially detracting from patient care.

Historically, the healthcare industry has struggled to support providers (especially independent practices) in managing these challenges effectively. Without proper support and infrastructure, the transition to VBC can be overwhelming and counterproductive.

This is why Chamber created our tech-enabled solution designed specifically to help provide the infrastructure and administrative support required to run value-based care models effectively, free of charge to cardiologists.

Empowering Providers to Excel in a Value-Based Care Environment

As the healthcare industry transitions to value-based care, the challenges of compliance, coding, and administrative burdens can feel overwhelming to providers. At Chamber, we’re dedicated to supporting healthcare providers through this transformation.

We provide seamless data and software integration, complete with an embedded user experience with real-time insights and notifications, task management, and communication across care teams. Our tech-enabled clinical care delivery helps identify evidence-based clinical guidelines and potential risks for all cardiovascular diseases.

We also offer comprehensive reporting and analytics capabilities that allow providers to monitor practice and provider performance, track quality benchmarks, identify trends in patient health outcomes, and more.

We believe in creating an environment where healthcare professionals can concentrate on what matters most: delivering exceptional patient care.

Ready to learn what Chamber can do for your team? Book a call to get started.