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The Advantages of Value-Based Care for Seniors on Medicare

Wouldn’t it be wonderful if your doctor was compensated according to your well-being, rather than the services they provide? Instead, providers are paid for the number of patients they see, the medications they prescribe and the procedures they order. But it doesn’t have to be that way. 

 

The health care landscape is always changing, and value-based care is at the center of it. Value-based care is an alternative approach to health care that focuses on outcomes, collaboration and patient satisfaction.

 

This approach to health care is especially beneficial for older adults and seniors on Medicare. In this blog post, we’ll discover how value-based care can address some of the challenges that are unique to seniors on Medicare. Check out the accompanying infographic for a quick summary of what value-based care can offer you.  

In this article, we will delve into the concept of value-based care, highlight its key distinctions from the traditional fee-for-service health care model and discuss why it holds tremendous importance for patients, doctors and insurance agents alike. 

Challenges of the Health Care Industry

In 2023, nearly 60 million Americans are enrolled in Medicare. As the Boomer Generation continues to age, the number of Medicare enrollees will only increase. This poses a variety of problems for the health care industry.

Rising Health Care Costs

A quick trip to the grocery store is enough to see the effects of inflation, but did you know that health care costs are rising even more dramatically than the cost of your bread? A study found that since 2000, the cost of consumer goods and services rose by 78.2% while the medical industry saw an increase of 155.1%.

Lack of Coordinated Care

It’s no secret that the health care industry needs workers. Whether in retirement facilities, hospitals or doctors’ offices, health care workers are burnt out from the effects of a pandemic. Try as they might to cover their bases, this has left care fragmented and uncoordinated when you’re switching between your primary provider and specialists. A recent study showed that 30% of patients have switched providers in 2021. With so much transition, it’s necessary to have coordinated care that shares information, so no health concerns fall through the cracks.

Focus on Quantity Over Quality

Did you know that providers are paid for the number of patients they see and the procedures they prescribe? When you’re looking for a provider, it’s important to find one that will take their time, rather than rushing to see the next patient. But how?

 

With NewPrimaryCare.com, we can connect you with a doctor who practices value-based care.  

What is Value-Based Care?

Value-based care is a new approach to health care. This model strongly emphasizes preventative care and collaboration between patients and providers to work for better health outcomes. This often results in more quality and thorough care and is linked to higher patient satisfaction.

 

Another difference is the pay incentive. Doctors and health care providers who use the fee-for-service model are paid based on the number of patients seen and procedures given. In comparison, health care workers using the value-based care model are rewarded according to the patient’s outcomes.  

How Value-Based Care Helps Seniors on Medicare

Medicare patients often have needs that are unique to their age, health history and situation in life. Value-based care can help seniors in the following ways:

Improved Health Outcomes

The easiest way to improve health is to focus on prevention. Value-based care helps seniors on Medicare to form healthy habits that prevent health problems or manage the chronic conditions that they face. By emphasizing a healthy lifestyle of regular exercise, screenings and vaccinations, providers can improve patient outcomes. According to the Blue Cross Blue Shield, Value-based care helps reduce hospital readmission rates by 3%, emergency room visits by 14% and mortality rates among seniors by 40%.

Wholistic Patient-Centered Care

Additionally, value-based care addresses the patient’s entire situation rather than simply the physical problem. For seniors on Medicare, this considers any challenges with memory, finances or social support. This approach helps create a more patient-centered care model that addresses not only the medical aspects but also the social, emotional and financial factors that can influence a patient’s overall well-being and treatment outcomes.

Affordable Health Care

For aging adults and seniors on Medicare, the value-based care model prioritizes preventive care, early interventions and evidence-based treatment. An 8-year study reported by the New England Journal of Medicine found that value-based care saved patients up to 11% on their medical costs. This reduces the need (and associated costs) for future procedures, medications or emergency room visits. Value-based care is more affordable and more accessible, dismantling the barriers to a healthy lifestyle.

Adherence to Medication and Care

When patients of a value-based care model received medical advice, there was an average 5% increase in adherence to the advice given for conditions like diabetes, high blood pressure and hypertension. This can be attributed to the emphasis on relationship building between providers and their patients. When relationships are built, trust forms and medical advice is more likely to be acted upon.

Increased Health Care Access

Value-based care prioritizes outcomes that lead to more cost-effective care. This approach to health care relieves the financial burden on vulnerable populations, making health care services more accessible to everyone. By focusing on patient-centered care, value-based care addresses unique needs and challenges, such as language barriers, cultural sensitivities, transportation limitations and food security.

Enhanced Care Coordination

As older adults age, they may downsize or move into a retirement community or assisted living. Care coordination emphasizes continuity of care so that patients can build long-term relationships with their providers. But sometimes that’s not possible. Depending on the patient’s situation, health care providers may change. This way, information can be shared to ensure a seamless transition between health care facilities.

 

Sometimes care coordination is more than a convenience, it’s essential for seniors who have a variety of chronic conditions. In a value-based care environment, specialists work together to improve a patient’s condition. When health care workers collaborate, information is shared. It avoids duplicate treatments and increases the quality of care.

Chronic Condition Management

When one in four Americans live with chronic medical conditions, value-based care plays an important role in helping seniors to manage illnesses like heart disease, diabetes or hypertension. With an emphasis on proactive measures, seniors with a value-based care model are encouraged to have regular screenings, patient education and a healthy lifestyle. This often leads to significant improvements in patient outcomes, including reduced hospitalizations, better medication adherence and enhanced overall quality of life for seniors.

Emphasis on Quality and Evidence-Based Care

Value-based care emphasizes care that is quality and evidence-based. While there are a lot of opinions about health care, value-based care relies on evidence-based strategies that improve a patient’s quality of life in ways they can see every day.

Increased Patient Satisfaction

Patient satisfaction is a key metric for providers of value-based care. Patient feedback and experiences are considered as a means to improve the delivery of care. This can be attributed to the amount of time that physicians spend with their patients.

 

Using a value-based care model, providers spend more time seeing individual patients, because they see 60% fewer patients on average. This approach helps seniors and aging adults to feel heard, valued and involved in their health care decisions. It builds trust with the seniors and leads to greater overall satisfaction.

 

When patients are more satisfied with their health care providers, they are 28% less likely to change providers, said a report from the management consulting firm, McKinsey & Company.

Ready to Learn More?

Visit NewPrimaryCare.com

Value-based care has grown 10% since 2021. NewPrimaryCare.com connects seniors on Medicare with value-based health care providers. Learn more about how value-based care provides superior health care service by attending our next event or finding a doctor near you.

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