The state of American health care is simply unsustainable and reform is desperately needed. Costs are rising faster in the United States than anywhere else, and Health care is now a shocking 18 percent of our national GDP. That figure is nearly double the global average and represents approx. $3.2 trillion dollars in health care spending.
Unfortunately, that means medical costs for a family of four (assuming employer-provided PPO insurance) have increased nearly 180 percent since 2002. But household income has barely moved since then, which means American families are diverting more and more of their hard-earned dollars toward health care.
BUT THERE IS A SOLUTION…
Population Health Management (PHM) and Value-Based Care (VBC)
WHAT IS POPULATION HEALTH MANAGEMENT?
It is collecting and analyzing patient data, aggregating it to segment the patient population and stratifying risk (into low risk, rising risk, and high risk), transforming that data into a single, actionable patient record, uncovering and filling gaps in care, aligning physicians, coordinating care, optimizing efficiency and reducing costs.
PRIMARY BENEFITS: Improving clinical and financial outcomes, reducing the onset of disease, slowing disease progression, and helping patients live happier, healthier lives.
WHAT IS VALUE BASED CARE?
It is a healthcare delivery model in which providers, including hospitals and physicians, are paid based on patient health outcomes rather than volume of services provided. Under value-based care agreements, providers are rewarded for helping patients improve their health, reduce the effects and incidence of chronic disease, and live healthier lives.
Value-based care differs from a fee-for-service or capitated approach, in which providers are paid based on the amount of healthcare services they deliver. The “value” in value-based care is derived from measuring health outcomes against the cost of delivering those outcomes.
PRIMARY BENEFITS: Patients spend less money to achieve better health. Providers become more efficient and provide superior quality care resulting in greater patient satisfaction. Payers control costs and reduce risk by spreading it across a larger patient population. Suppliers align prices with positive patient outcomes and reduced care costs. We become a healthier society while reducing overall healthcare costs.
AS MORE HEALTHCARE PAYERS ADOPT VALUE-BASED PAYMENT MODELS, PROVIDERS MUST ADVANCE THEIR POPULATION HEALTH MANAGEMENT STRATEGIES.
But healthcare organizations navigating the transition are faced with a dilemma: They don’t have the data, technology or human capital to support the transition, and they are not operationally structured to provide and manage care before, after and in-between visits—which is largely untouched by encounter based medicine and essential to a more effective health care system.
Here’s where we can help.
Vigilance Health’s value based care solutions provide population health management technologies combined with care management, practice transformation and quality improvement teams. We empower healthcare organizations with strategies and programs that reduce the financial burden and facilitate the transition to these new care delivery models—at a comfortable pace with the least amount of operational discomfort.
Our suite of services revolve around a unique team of healthcare professionals who have skills and attributes that compliment—rather than replace—a physicians supporting staff. The Vigilance care team performs as an extension of a private practice or health system, brings with them today’s cutting edge population health and care management technologies, and provides care programs that address patient health in-between care encounters. This not only helps providers improve patient care and increase revenue, but it offers them a low-risk way to gain experience and proficiency with population health management and value-based reimbursement models without upfront costs, technology investments or additional staff.
For detailed guidance on how to begin the transition to value-based care using population health management service lines, please contact us here to schedule a complimentary consultation with a Vigilance Health Population Health Management Specialist.