How Value-Based Care Supports Ongoing Condition Management

The Transformative Impact Of Value-Based Care

Insurance companies recognize the benefits of rewarding doctors and health professionals for an outcomes-based approach. As a result, value-based programs are being rapidly adopted in the healthcare space under a “fee-for-value” model, in contrast to a traditional ​“fee-for-service” model.

When whole-person care is the center of a doctor’s focus, your employees may benefit from increased provider-patient collaboration and receive more appropriate tests, medications, and medical procedures. They may pay lower care costs, experience better health outcomes, and even prevent the onset and progression of certain chronic conditions.

Value-Based Care And Chronic Disease Management

According to the Centers for Disease Control and Prevention, 6 out of 10 adults have a chronic disease such as heart disease, diabetes, cancer, or asthma. In addition to being the nation's leading causes of death and disability, ongoing chronic conditions are also the driving force behind annual healthcare costs, which are expected to reach $6.2 trillion by 2028.

High-cost conditions often require complex and expensive tests, medications, medical devices, and surgical procedures. On the other hand, many conditions can be improved, delayed, offset, or better managed by enhanced support from care providers.

Here are two examples of how patient-centered care may improve chronic condition outcomes:

Diabetes: The average U.S. healthcare costs for a person with diabetes was around $12,000 in 2021 and approximately $1 out of every $4 U.S. healthcare dollars is spent caring for people with diabetes — more than any other country in the world.

Value-based care encourages doctors to take a comprehensive look at patients’ overall blood sugar management. That may include education on administering insulin, a dietitian referral to learn about low-glycemic foods, or sessions with a fitness professional to support an achievable exercise plan.

A patient-centered doctor might also connect an individual to a community diabetes educator, or make sure they’re up to date on eye exams to check for diabetes-related eye conditions. This type of comprehensive care could significantly improve the lives of patients with diabetes, prevent costly health complications, and even reduce emergency room visits.

Heart disease: As the leading cause of U.S. deaths, heart disease has a national economic toll amounting to $363 billion each year. A value-based approach seeks to improve outcomes for individuals with heart disease and reduce these costs.

Patient-centered care doctors want to prevent health problems before they occur, so they may prioritize heart health for high-risk patients or those with a family history of heart disease. This could include conversations about dietary and lifestyle modifications, or how to recognize warning signs and symptoms.

They may recommend using a wearable device to track heart rate irregularities, suggest one-on-one coaching from a health professional, or help patients make better-informed decisions about where to receive expensive cardiology procedures.

Advancing Patient-Centered Care While Lowering Costs

Health companies like Anthem continue to develop solutions creating synergies between value-based models and enhanced patient-centered care:

• Anthem Link connects your employees to primary care physicians and offers personalized whole-health support, including virtual care visits and a user-friendly digital experience.
• Anthem’s Well-being Coach program engages your employees with the right resources at the right time to make a healthy difference in their lives, add value, and help improve costs. 
• Cancer Care Navigators collaborate closely with employees’ cancer care teams to stay in lockstep with treatment plans and overall healthcare decisions.

Patient-centered care and value-based programs have become a way for providers and insurers to partner together, driving both improved health outcomes and lowering costs of care. When doctors focus on care management, chronic condition prevention, and overall whole health, everyone benefits.

The Virtual Primary Care experience is offered through an arrangement with Hydrogen Health.