Today, consumers are paying a larger portion of the costs associated with their health care and have more control over health-related decisions. Unfortunately, costs seem to be consistently skyrocketing.
As a physical therapist, you have access to behind-the-scenes information and standards that will offer optimal care to your patients at lower costs. Health plan programs, systems, doctors, and specialists are now working together to develop solutions for patients that will not only reduce the amount of out-of-pocket expenses that they incur but, will also optimize their health on a long-term basis.
The most promising of these solutions is value-based care. In this guide, you will learn how this form of care will immensely benefit your patients and your practice.
What is Value-Based Care?
Value-based care is an emerging trend in the healthcare field – especially among physical therapists. At this point in time, it is likely that you are very familiar with the concept. It is a highly popular solution that is designed to directly address the issue of ever-increasing health costs, the inefficiency of the practices in the clinical setting, and the unnecessary duplication of health services.
Value-based care is designed to help patients obtain the care that they need, at a reasonable price. It is a solution that is designed to provide patients with the exact treatments that they need when they need them the most – especially those that are perplexed with chronic medical conditions.
Traditionally, health care was given in a volume-based, fee-for-service manner; however, this has since been deemed ineffective for patients and their long-term health.
The Four Models
As a physical therapist, it is imperative that you understand that there are – currently – four distinctive value-based care models. Outlined below, you will find the name and a brief description of each:
- The Accountable Care Organization – Often referred to as the “ACO” this model strives to optimize patient satisfaction, the quality of care that patients receive, and the costs associated with that care. Doctors, specialists, and medical facilities that use this model focus on preventive care and focusing on services that are on a “need-only” basis.
- The Patient-Centered Medical Home – Often referred to as the “PCMH”, this value-based care model is often led by a medical doctor that has the desire to offer enhanced health care and coordination in the health care system, as a whole.
- The Pay-For-Performance – Often referred to as the “P4P”, this value-based total care model provides rewards to providers that are able to offer high-quality services and care. This model acts as an incentive for exceeding expectations and improving health care for patients.
- The Bundled Payments – This model provides one payment to a doctor, a physical therapist, or a practice that covers all of the services provided to a patient for a specific type of care, such as the replacement of a knee or the replacement of the hip. It outlines the costs and expectations of specific types of treatments for certain conditions so that costs are unified across all providers.