First introduced in the mid 2000’s, value-based care was brought to the forefront of medical practice with the 2015 passage of MACRA1. Designed to treat the entire patient, both in illness and health, and reward improved health, value-based care was the antidote to a fee-for-service (FFS), solely treatment- and diagnostic-based approach to the practice of medicine. In theory, it was exactly what both doctors and patients needed to create a culture of improved health and reduce the healthcare system burden of disease. So why, then, has it failed so spectacularly thus far?
While it’s nearly impossible to attribute just one, or even a handful of causes to the lack of traction or success for value-based care, it is possible to assess influence and recommend focused avenues for positive change. Here are a few key areas where changes could have a profound impact and lead to greater success for value-based care.
If you’ve been considering advance care planning (ACP), you’re in good company. More than 90 percent of Americans believe it is important to discuss the treatment and palliative options they would choose to pursue if they were to become incapacitated by medical issues in the future, according to The Conversation Project’s 2018 National Survey. Yet, they also report that only 32 percent have actually conducted these conversations.
Why? Most people don’t know where to begin. Some don’t even fully understand what advance care planning entails. But there is someone who can help: your doctor. Here’s how.
Data in healthcare is now essentially ubiquitous: there are mountains of it everywhere. With the promise of tech and big data, healthcare systems snapped up technology that promised to capture all their data and provide enhanced and unprecedented insights. EHRs were pushed on physicians, claiming better data collection, organization, and utilization. And yet, very few physicians can even access real-time information, let alone derive practice-informing insight from it1. How then, do we bridge the gap from data ubiquity to real-time, meaningfully informed medical practice?
The COVID-19 pandemic has had far-reaching, often unanticipated consequences across every facet of life, from commerce and labor to social life and education. Unsurprisingly, it has also impacted health care; however, its influence has ranged far beyond debates over vaccines and mask mandates.
Much of the population has had to deal with inadequate advance care planning (ACP). Described by the NIH as the process of learning about, considering, and communicating preferences regarding the decisions that need to be made in an emergency or end of life situation1, ACP is generally considered the realm of the elderly and chronically infirm. The COVID-19 pandemic brought that perspective into sharp contrast, though, as it unselectively ravaged both the young and old, healthy and chronically ill. Even frontline health care personnel weren’t spared as COVID-19 tore through the masses, highlighting the need for increased awareness and implementation of ACP.
It is no secret that healthcare has been in crisis — a staffing crisis. While the pandemic certainly exacerbated the situation, present workloads, emerging patterns contrary to traditional practice, and burnout are only the latest in a long line of factors straining the healthcare workforce.
Providers, labor experts, and public health entities alike have been decrying a looming and extended shortage of healthcare workers for over two decades1. Specifically, primary care providers and nurses have been the subject of many workforce studies, in an attempt to understand and mitigate the consequences of understaffing, but they do not represent the full impact of healthcare staffing shortages.