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The Rise of Value-Based Care and the Future of U.S. Healthcare

In this week’s email:

• Today’s Insight from AgingHere

• The Transformative Potential of Value-Based Care in U.S. Healthcare

• Home is Where the Healing Is, The Rise of Value-Based Care in a Changing Landscape

• Bridging Home Care and Technology for Tomorrow’s Healthcare

• VBID 2023, Navigating the New Landscape of Hospice Care and Health Equity Initiatives

• Today’s AgingHere Survey

• Making us laugh this week

• AgingHere Referral Program

• Today’s Sponsor: Mastering Medicare Podcast (MasteringMedicare.net)

Today’s Insight from AgingHere

In a transformative shift from the traditional fee-for-service model, the U.S. healthcare system is increasingly embracing Value-Based Care (VBC). This model, backed by the Centers for Medicare and Medicaid Services, incentivizes providers based on the quality and results of care, aiming to strike a balance between cost-effectiveness, quality, and equity. By 2030, an expansive enrollment into VBC programs is projected, addressing the prevailing gap between high healthcare expenditures and the actual quality of results.

Further complementing this movement is the rise of home-based post-acute care. With a growing preference among senior adults to age at home, the convergence of VBC with home care offers an innovative approach to holistic patient care. This new paradigm focuses on prevention, efficiency, and a comprehensive view of patient health, diverging from fragmented traditional systems. Moreover, as the pandemic underscored the versatility of home care, the integration of mobile health technologies is proving instrumental in augmenting patient-centered solutions, ensuring safety, and emphasizing the significance of patient voice and choices.

Lastly, as the Value-Based Insurance Design (VBID) ventures into its third year in 2023, the hospice landscape is set for significant revisions. The program aims to gauge the efficacy of payers and providers within Medicare Advantage, with an increasing emphasis on in-network providers. This transition not only signifies a growth in participation but also introduces initiatives like the Health Equity Incubation Program, emphasizing the eradication of disparities in healthcare outcomes. As healthcare continues its evolution, the intertwining of value-based models, home care, and technology promises a future marked by quality, equity, and patient empowerment.

The Transformative Potential of Value-Based Care in U.S. Healthcare

Value-based care links healthcare providers' earnings to the quality and results of care they offer patients, aiming to correct the U.S. fee-for-service system's misaligned incentives. By 2030, the Centers for Medicare and Medicaid Services plan to enroll all Medicare and most Medicaid beneficiaries into such programs. The U.S. spends significantly on healthcare but often doesn't achieve top results. Value-based care hopes to address this by emphasizing quality, cost-effectiveness, and equity over service volume. These programs may lower costs, improve care quality, and foster care team collaboration. Key success metrics include care effectiveness, efficiency, equity, patient satisfaction, safety, and timeliness. The approach combines financial incentives, measurement, accreditation, regulation, and public reporting. read more.

Home is Where the Healing Is, The Rise of Value-Based Care in a Changing Landscape

The U.S. healthcare system seeks order amidst chaos. Value-based care (VBC), where providers are paid based on patient outcomes, offers hope to reform the system. As an increasing number of patients prefer home-based care, VBC's potential is magnified. With 90% of senior adults aiming to age at home, the simultaneous rise of VBC and home-based post-acute care presents a unique chance for healthcare reform. This coordination focuses on whole-patient care, emphasizing prevention and efficiency, differing from fragmented fee-for-service systems. Cheri Rodgers highlights the potential of marrying VBC with home care, advocating for coordinated healthcare delivery. read more.

Bridging Home Care and Technology for Tomorrow’s Healthcare

Home-based care reduces the strain on the healthcare system, allowing patients to remain at home. For it to succeed, prioritizing patient voice, safety, and caregiver training is essential. However, challenges include patient acceptance, safety concerns, and clinician training. Solutions encompass valuing patient choices, utilizing data management software for patient safety, and integrating home care training in medical curriculums. The COVID-19 pandemic highlighted the potential of home care, pushing the shift towards patient-centered solutions, and showcasing the efficacy of mobile health technologies in transforming healthcare services and patient outcomes. read more.

VBID 2023, Navigating the New Landscape of Hospice Care and Health Equity Initiatives

The hospice component of the Value-Based Insurance Design (VBID) enters its third year in 2023, introducing changes to the program's rules. This "MA hospice carve-in" evaluates payer and provider performance in Medicare Advantage (MA). In 2023, established Medicare Advantage Organizations (MAOs) can offer incentives to use in-network providers, while new entrants adhere to earlier requirements. Participation in the VBID hospice component is set to increase, with 119 health plans across 806 counties in 24 states. A new feature, the Health Equity Incubation Program, focuses on addressing disparities in healthcare outcomes and experiences. read more.

Making us laugh this week:

AgingHere Referral Program

Today’s Sponsor: Mastering Medicare (MasteringMedicare.net)

Listen to Mastering Medicare Podcast Episode 23: Medicare broker deep dive - interview with Matt Gibson from 90 Days From Retirement

AgingHere Inspirational Quotes

Caring for seniors is an act of love that enriches both the caregiver and the recipient.