Value-Based Care Will Change the Face of Medicine

October 2013, Vol 4, No 8 - Value Propositions

In a recent guest blog on the Harvard Business Review website, Toby Cosgrove, MD, President and CEO of the Cleveland Clinic in Ohio, suggested that value-based care represents a life-saving “breakthrough,” not unlike penicillin or decoding the human genome, by focusing on lowering costs and improving quality of care and outcomes as its main goals. According to Dr Cosgrove, value-based care “is being slowed by criticism, misunderstanding, and reluctance to do things differently,” but it is inevitable, and it will change the way medicine is being practiced in this country.

Value-based care “will eventually affect every patient across the United States. Not everyone, however, is on board yet, because part of the value-based equation is that hospitals will be paid less to deliver better care. That’s quite a challenge, but one that the Cleveland Clinic is embracing as an opportunity to do better. Others must, too,” says Dr Cosgrove.

Value-based care, Dr Cosgrove notes, is moving away from a fee-for-service reimbursement model to a system that rewards quality and patient outcomes. “No longer will health care be about how many patients you can see, how many tests and procedures you can order, or how much you can charge for these things. Instead, it will be about costs and patient outcomes: quicker recoveries, fewer readmissions…lower medical errors….In other words, it will be about value. And that is good.”

He predicts that as medicine is increasingly becoming a data-driven science, there will be further consolidation from community hospitals to large hospitals that are driven by physicians “based on what is best for the patient.” Reducing waste and unnecessary procedures or tests are keys to lowering costs without compromising quality.

“A key part of the cost solution is to educate all caregivers, including doctors, about what items cost,” Dr Cosgrove says. Although he is not focused specifically on cancer care, many cancer centers and networks are hard at work to find ways to incorporate value-based care in their cancer care delivery and consider cost-effective alternatives where such alternatives are available. Harvard Business Review Blog Network; September 24, 2013