Value-Based Care
Value-based care refers to a health care model within which health service providers, who may include hospitals, as well as, physicians, are paid for services rendered based on the health outcomes for individual patients (Tinetti, Naik, & Dodson, 2016). The basic idea associated with value-based care is to ensure that patients receive value from the quality of care offered while ensuring that they achieve the best possible health outcomes. Over the years, several vital legislations have been enacted as part of shifting towards value-based care. These include Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), Patient Protection and Affordable Care Act of 2010 (ACA), Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), and Protecting Access to Medicare Act of 2014 (PAMA). Each of these legislations enacted has had important implications for ensuring that the quality of care offered is improved significantly while seeking to establish a front through which patients achieve the best possible outcomes. The eight CMS value-based programs are; End-Stage Renal Disease Quality Incentive Program (ESRD-QIP), Hospital Value-Based Purchasing Program (HPVP), Hospital Readmissions Reduction Program (HRRP), Hospital-Acquired Condition Reduction Program (HACRP), Value Modifier or Physician Value-Based Modifier (PVBM), Skilled Nursing Facility Value-Based Purchasing Program (SNF-VBPP), Alternative Payment Models (APMs), and Merit-Based Incentive Payment System (MIPS) (CMS, 2019).
Patient-Centred Care
Patient-Centred Medical Home (PCMH) refers to a health care model within which treatment for patients is well-coordinated where the primary physician, who is the main caregiver, is involved in ensuring that the patients receive necessary care whenever necessary in a manner that the patients understand (Adaji, Melin, Campbell, Lohse, Westphal, & Katzelnick, 2018). The basic idea associated with PCMH is to facilitate quality care services for the patients at any given time while considering the need to ensure that the patients are involved at all times. PCMH introduces a centralized approach to health service delivery that seeks to emphasize on coordinated care that is determined based on the expected appropriateness for the patients. The value of patient-centred care can be seen from the fact that it helps improve the satisfaction scores among individual patients, as well as their immediate families. By providing patient-centred care, patients achieve higher levels of satisfaction regarding the quality of care provided, as such services often match the overall expectations for the individual patients. On the other hand, patient-centred care also plays a crucial role in enhancing the reputation of providers involved in health care service delivery at different levels.
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High-Reliability Organizations
High-reliability organizations (HROs) refers to organizations that can avoid possible catastrophes irrespective of the fact that they are often faced with notable risks and complexities that are likely to affect their overall capacities to achieve best possible outcomes (Vogus & Iacobucci, 2016). HROs were developed as a result of notable failures by organizations to withstand potential catastrophes that impact their capacities to deliver on what was expected of them. In such cases, the organizations often experienced significant challenges in dealing with risks that they encountered, which was a significant limitation on their part. The journey for health care organizations to define themselves as HROs can only be determined based on two main aspects, which are patient safety and efficient health care delivery. By promoting patient safety, as well as advancing service delivery, health care organizations can project themselves as being much more reliable focusing on their expectations. That means that the hospitals can project themselves as being somewhat useful in establishing their abilities to provide the best possible care services.
References
Adaji, A., Melin, G. J., Campbell, R. L., Lohse, C. M., Westphal, J. J., & Katzelnick, D. J. (2018). Patient-centred medical home membership is associated with decreased hospital admissions for emergency department behavioural health patients. Population health management , 21 (3), 172-179.
CMS. (2019). Value-based programs . Retrieved from https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/Value-Based-Programs
Tinetti, M. E., Naik, A. D., & Dodson, J. A. (2016). Moving from disease-centred to patient goals–directed care for patients with multiple chronic conditions: Patient value-based care. JAMA cardiology , 1 (1), 9-10.
Vogus, T. J., & Iacobucci, D. (2016). Creating highly reliable health care: How reliability-enhancing work practices affect patient safety in hospitals. ILR Review , 69 (4), 911-938.
