Risk and Reward of Value-Based Care

With hopes of reducing overall healthcare spend, now at 18% of the GDP and rising, the government is looking to value-based care (VBC) to provide a better overall experience for people and reduce costs system-wide. While VBC is a risk to payers, systems, and providers, it’s also rewarding the consumer in a way that puts money where the value is. An opportunity noted in a whitepaper on ‘The Science Behind Modernizing Health Organizations for Value-Based Care’ from SS&C Health, ‘for health plans to add value and deliver a more personalized experience.’

Lifesprk’s CEO, Joel Theisen, BSN, has been vocal about Lifesprk’s position on VBC believing this is the future of a better senior services delivery system that is an alternative to the fragmented, ‘sick-care,’ and reactive system contributing to skyrocketing costs rather than rewarding value with payment.  “I am not okay with the current experience seniors face,” explained Joel. “I believe we need to band together and deliver on a longitudinal, person-centered, wholistic delivery system.  Proving efficacy is the catalyst for change. We are a first-world country spending two times as much on healthcare with no better outcomes.”

At Lincoln Healthcare Leadership’s upcoming Healthcare Innovation & Investment Conference (Hi2), Joel will share his vision on Lifesprk’s proven whole person senior care population health strategy, paving the way for some VBC announcements of our own. Hi2 organizers know much of the change that needs to occur is being driven from outside of the traditional healthcare services ecosystem, from new, disruptive players, like Lifesprk.  The goal of the Hi2 conference is to share new disruptive business models with leading private equity investors, providers, and payers, stimulating more investment and learning for faster change in our system.

The vision for this type of care comes as no surprise to Lifesprk who has been working to stop the ‘roller coaster of health care crises’ for 15 years, long before VBC became a government mandated payment structure and trending buzzword.  The value is felt by clients like Ruthie, who fell while at her senior living campus breaking her pelvis. Because her integrated Lifesprk team works seamlessly together between Medicare skilled home health (Lifesprk Home Health), primary care (Lifesprk Health), and private-pay nursing (Lifesprk Community Home Care), she was able to get everything she needed in one place – her home. Ruthie never needed to go to the ER or hospital as you’d suspect, instead within hours, she was enjoying lunch with friends. This community-based delivery system achieved triple aim objectives:  improved experience and health outcomes with reduced cost – that’s value-based care.

What do providers need to do now to get ready for VBC? It’s about building the technology that allows organizations to leverage data to demonstrate value through outcomes. “The value though is more than financial performance and meaningful outcomes like decreasing re-hospitalization and emergency room visit rates and increased keepage to other system-based services,” said Joel. “We have to measure social determinants of health, too, and overall client-reported wellbeing. This is the value consumers are looking for, while the outcome of that focus is what healthcare systems desire.”

We know VBC can be risky but not pursuing these solutions can put the health of our senior population at risk. As Joel has said before, this is a call to action – we need to be rewarded and focused on bringing wellbeing and independence to create the change this nation needs. That will be the ultimate reward for us all.

Share with us your thoughts – is VBC too risky or is it worth the reward?