Analyze the current economic shift from volume-based health care to value-based health care.
Healthcare providers have been facing increasing pressure from purchasers and consumers to be value-driven. Value-driven care is a delivery framework aimed at improved health outcomes at a lower cost, enhancing patient experiences while improving individuals' health. The shift aims to increase the patients' value for money, with the health providers' focus being to deliver the value efficiently with attention on outcomes than just the number of services sought
In the traditional setting, the providers were paid on the volume of services provided without considering whether extra services had better outcomes for the patients. The business model was mainly volume-based; more patients attended meant more payments (Terrel et al.,2020). As the transition is happening, the healthcare providers are paid not only based on the quality of care given but also on efficiencies. The approach has enabled the payers to control extraordinary costs and improve on profit margins while providers can improve efficiencies of operations and have improved relationships with patients.
Delegate your assignment to our experts and they will do the rest.
What economic principles (macro and micro) are driving this shift?
One of the micro-economic factors includes the growing emphasis on a deeper collaboration between the physician and the hospital systems to collect more information on the intervention best suitable and valued by specific healthcare consumers. The business leaders and the payers should develop innovative products, track, analyze and educate their teams of the multi-dimensional value in the health plans created (Alokozai et al.,2019). There is a range of industry-related factors at the macro-economic level, such as declining government payments and changing demographics. Also, regulatory changes at federal and state levels are compelling players in healthcare to institute changes on where and how patient care is delivered, now and in the future (Kalkhof, Bajner & Leibach, 2017) . The fee-for-service revenue model had outlived its lifespan and had become a threat to the survival and sustainability of the healthcare system in the United States. Therefore, a more radical approach was needed.
Evaluate the implications of this volume to the value shift
The impact of the transition is multi-dimensional. It has benefits for all the industry stakeholders, including the patient, insurance companies, and medical technology solution providers. The patients are assured of better health solutions and outcomes at low costs while the insurance companies can improve cost control and better margins (Bogan, 2019) . Medical technology providers can enhance revenues and margins since their payments are tied to patient outcomes.
How has this shift affected how you work or how you or a family member has been treated for a medical condition?
How has this shift affected how you work?
As a working nurse, the value-based approach has impacted the profession in a significant way. The nurses are supposed to keep up with the electronic health records, and the procedures have to be done precisely at the stipulated time. Punishments may come even if failure to perform the task is a result of an emergency intervention. A lot of emphases is on the importance of documentation of care administered compared to actual care given.
References
Alokozai, A., Jayakumar, P., & Bozic, K. J. (2019). Value-based Healthcare: Improving
Outcomes through Patient Activation and Risk Factor Modification. Clinical Orthopaedics and Related Research , 477 (11), 2418–2420.
Bogan, M. (2019). Who Benefits from Moving Health Care from Volume to Value? Retrieved
21 January 2021, from http://www.ihi.org/communities/blogs/who-benefits-from-moving-health-care-from-volume-to-value
Kalkhof, C., Bajner, R., & Leibach, J. (2017). Integrating Healthcare Revenue and Operating
Models to Create a Sustainable Future. Retrieved 21 January 2021, from https://www.hfma.org/topics/article/56184.html
Terrell, G. E., & Bobbitt Jr., J. D. "Bo." (2020). Development of Care Models--Value-Based
Healthcare and Payment Models. Physician Leadership Journal , 7 (5), 77–78. http://eds.a.ebscohost.com/eds/detail/detail?vid=9&sid=7bc41f73-8e98-4a7a-853d-6000194f7671%40sessionmgr4008&bdata=JkF1dGhUeXBlPXNoaWImc2l0ZT1lZHMtbGl2ZSZzY29wZT1zaXRl#AN=146843006&db=buh
https://doi.org/10.1097/CORR.0000000000000985
