The healthcare system has traditionally followed a fee-for-service (FFS) model, which effectively compensates providers for each service they provide. One of the problems with the model is it inherently drives providers towards wanting to provide more services in order to increase revenue. As a result, there tends to be more of a focus on increasing patient numbers and potentially providing tests or other services that may not always be necessary, rather than focusing entirely on quality of care.
It’s one of the factors that has created significant inefficiencies and increased healthcare costs in the U.S., which spends more per capita than any other developed nation. In recent years, though, value-based care (VBC) has become a growing area of focus, as regulators look for ways to control costs and manage the healthcare needs of more patients (including a growing number of older patients suffering from chronic conditions).
But, value-based care isn’t growing as quickly as many would like, and the FFS model remains the dominant methodology – even though Accountable Care Organizations, bundled payments, and Patient-centered medical homes are emerging in some places. Still, since the Affordable Care Act was passed in 2010, there has been more attention given to how the healthcare system can evolve to meet the needs of both providers and patients, and ensure high-quality care in the lowest-cost settings.
The shift to value-based care is clearly not a change that will happen instantly, and most providers will likely go through a transition period where they are following both models to a degree. In fact, it may be a long time before the FFS model is the exception rather than the rule. In the meantime, many of the technologies and processes that are part of the connected health landscape and are poised to drive value-based care can help providers generate revenue in a FFS environment while preparing them for the eventual transition to VBC.
Remote Patient Monitoring
Remote patient monitoring allows providers to continuously monitor patients and react quickly to changes in conditions. In this sense, it’s effectively a gateway to value-based care, as faster intervention can prevent worsening conditions that could require in-person visits, hospitalization, or other types of higher-level care. Providers can also leverage virtual visits to immediately engage with patients or caregivers to quickly discuss health alerts, rather than requiring in-person consultations. At the same time, being able to monitor patients in their home settings can allow providers to free up more office time for in-office fee-for-service based patient appointments.
Synchronous Virtual Visits
Synchronous (real-time) telehealth visits extend access to healthcare consultations to nearly any location. Physicians can consult patients on routine questions, perform initial visual exams, or have follow-ups related to previous visits, treatments, or existing conditions. Patients are able to conveniently engage with their physicians from anywhere, reducing their time commitment, while ensuring they have access to care when it’s needed.
The ability to leverage store-and-forward solutions allows physicians to share patient information with other medical professionals and specialists when consulting them for diagnoses or decision-making. Likewise, doctors are able to coordinate care more effectively for patients with multiple conditions, which can help ensure they provide the right treatment plans. By being able to share patient data – from historical health data to lab tests to MRI images – collaborating medical professionals can make more informed recommendations than if they were simply to have a phone call. The ability to collaborate can also reduce the need for patients to travel to multiple offices, reducing time commitments (and associated costs) for both providers and patients.
With an increasingly connected patient base, providers have more potential touchpoints with their patients. Depending on the need, they can leverage voice, video, text messaging (or other messaging apps), or even email. By increasing interactions with patients, they will become more aware of their own health. In addition, patients have access to a whole new set of digital tools and data that give them more information about and control over their health that can be shared with and leveraged by physicians to build holistic views of patients’ health – as well as supporting population health programs. As patients and caregivers become more involved in their own care, they are themselves moving towards a value-based model, which can again free up physicians to help more patients in the same amount of time.
There is no overnight answer to the healthcare efficiency problem. But, connected health technology can help bridge the gap between patients and providers as the financial models are sorted out. Connected health can enable providers to treat patients more effectively, and allow patients to receive care more conveniently, while also planting the seeds of value-based care into the system.