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Insights and Trends

The Rise of Value-Based Care: What It Is and Why Hospitals Should Prioritize Integration

CMS aims to have all Medicare beneficiaries and most Medicaid beneficiaries enrolled in accountable care programs by 2030.1 This growing rate of adoption could lead to a value-based care (VBC) market valuation of $1 trillion in the coming years – creating substantial value for payers and providers, notes a McKinsey and Company report.2

Understanding value-based care

Value-based care (VBC) is a CMS initiative set forth to improve patient outcomes through a hospital’s ability to supply high-quality, cost-effective care to all those in need of treatment.1

Through this initiative, hospitals focus more on the quality of care delivered and optimal outcomes achieved, rather than just the quantity of patients treated and discharged.

Why is VBC becoming more prominent across the nation?

Although the U.S spends much more of its gross domestic product (GDP) on healthcare than any other country, it continues to have the highest rate of preventable deaths.3

Longstanding inequities in healthcare, such as a lack of access to care in rural communities and less healthcare opportunities for those in lower socioeconomic neighborhoods, also play a major role in the U.S.’s challenge to achieve optimal patient outcomes.

VBC helps hospitals realign their values to make sure every patient receives the highest quality care possible. The patient can then discharge back into the community with a lowered risk of readmission for the same condition/illness – reducing cost for both the patient and hospital.

How can hospitals benefit from VBC integration?

Care settings such as inpatient rehabilitation facilities (IRFs) and acute rehabilitation units (ARUs) have always been focused on generating improved patient outcomes for a hospital. By adopting the VBC model, IRFs and ARUs can continue to build upon the mission of delivering high-quality care to the right patient at the right time in their care journey and get rewarded by doing so.

Key areas where rehabilitation hospitals can see the most improvement through VBC:

      • Financial Health

As noted above, a key area VBC is trying to address is that of cost. Rising costs for patient care, clinical resources and staffing are hindering hospitals from delivering the most effective care possible.

Through VBC integration, inpatient rehab hospitals can focus on the outcomes that matter most to the patient and, through an interdisciplinary team approach, can pinpoint the treatment protocols best equipped to address each patient’s unique needs.2 This approach reduces hospital resource expenditure and streamlines the patient care journey – therefore lowering length of stay, care cost and readmission risk.

      • Care Quality and Health Equity

Historically, patients have had to admit to different care settings to address each of their care needs. Yet, recent years of admissions data has shown that more and more patients require integrated care to effectively meet their unique needs.1

For example, hospitals that integrate inpatient rehabilitation and behavioral health programming into their care continuum are more likely to address each of their patients’ unique needs compared to hospitals with just one specialized program.

This simultaneous delivery of rehab and behavioral health treatment help to improve the patient experience and outcomes, as well as hospital operations. It also opens the door for more patients to receive treatment close to home and reduces potential care cost due to consolidated treatment programs.

Strategies to achieve an effective VBC program

Within the next five years, hospitals that integrate VBC into their care continuum could experience nearly 2X the rate of patient admissions compared to hospitals that do not adopt the VBC model.2

However, navigating the complex healthcare environment can become burdensome for hospitals. A key strategy that continues to prove beneficial for hospital operations and outcomes is partnership.

A contract management or joint venture partnership with a qualified rehabilitation expert allows hospitals to remain focused on delivering high-quality patient care without having to stay ahead of changing healthcare trends that often require additional resources and expertise at both the local and national level.

Contact us to learn how partnership with Lifepoint Rehabilitation can help your hospital improve patient care and outcomes.


References:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7185050/
  2. https://www.mckinsey.com/industries/healthcare/our-insights/investing-in-the-new-era-of-value-based-care
  3. https://www.commonwealthfund.org/publications/explainer/2023/feb/value-based-care-what-it-is-why-its-needed

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