Succeeding in Value-Based Care: Part 3

Redesigning Care Delivery and Management for Value-Based Care 

Summary: Value-based care requires rethinking healthcare delivery. Organizations can improve patient outcomes by focusing on proactive care, care coordination, and patient engagement. 

Welcome to the third article in our value-based care series for healthcare organizations. Our previous article explored the importance of data aggregation and actionable insights in this transformation. Today, we focus on a foundational element of value-based care: redesigning care delivery and management to prioritize prevention and proactive care. 

Transitioning to a value-based model involves reimagining how care is delivered. Traditional fee-for-service models often incentivize volume over value, rewarding providers based on the quantity of services rendered rather than the quality of care provided. In contrast, value-based care emphasizes patient outcomes, focusing on keeping people healthy and preventing disease. It fosters a shift from treating illness to proactively maintaining wellness.  

Below, we discuss a three-step approach to redesigning care delivery and management to align with value-based care principles. 

1. Shift From Reactive to Proactive Care 

Focus on prevention and early intervention. 

• Build Preventive Care programs: Integrate regular health screenings, immunization programs, chronic disease management initiatives, and wellness programs that promote healthy lifestyle choices. 

• Use Risk Stratification: Leverage data analytics to identify high-risk patients and intervene early. For example, patients with a family history of diabetes can be enrolled in a lifestyle modification program before they develop the disease.  

• Allocate Resources Efficiently: By stratifying patients according to their risk, providers can allocate resources more efficiently, focusing on where they will have the most significant impact. 

2. Enhance Care Coordination and Management 

A team-based approach allows for comprehensive care management and empowers clinicians to work at the top of their license. 

• Establish Multidisciplinary Care Teams: Bring together a team of healthcare professionals—primary care physicians, specialists, nurses, pharmacists, social workers, and others—to ensure holistic and patient-centered care.  

• Invest in Technology: EHRs and care management platforms can help track patient progress, flag potential issues, and facilitate timely communication among care team members.  

• Connect Digitally: Offer patient portals and telehealth services to improve communication and engage patients in their care. 

3. Prioritize Patient Engagement and Education 

Engaged, informed patients are more likely to achieve better outcomes. 

• Develop Patient-Centered Care Plans: Patients who are actively involved in their care are more likely to follow treatment plans. Consider the patient’s medical needs, preferences, values, and social circumstances.  

• Involve Patients: Developing care plans together ensures their plans are realistic, achievable, and aligned with their goals. This collaborative approach fosters trust and encourages patients to actively participate in their health. 

• Promote Health Literacy: Patients need to understand their conditions, treatment options, and the steps they can take to stay healthy. Healthcare organizations should invest in educational resources, including written materials, workshops, and online tools, to help patients make informed decisions about their care. 

• Use Simple Language: Avoid medical jargon in communication and educational materials.  

Organizations can improve patient outcomes, reduce costs, and thrive in the value-based care environment by shifting the focus from reactive to proactive care, enhancing care coordination, and engaging patients in their health.