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Forty years ago, at the height of the AIDS epidemic, HIV researchers and physicians discovered that simply treating the symptoms of the disease was not enough to provide lasting improvement for patients. Other factors like unstable living conditions, drug use, the public stigma over AIDS and HIV – known today as social determinants of health – all require attention in addition to a traditional treatment plan. This holistic view of the patient and caring for their symptoms, treatments, and the environment around them is what we know today as Value-Based Care (VBC).
From this perspective, one could say VBC has been part of our healthcare ecosystem for decades. We had the right medical guidelines and protocols in place, and physicians, clinics, and support systems were part of a whole person health management approach. And, it was successful.
In the decades since the HIV crisis, the emphasis in VBC has shifted away from patient outcomes to reducing costs for insurers. Sadly, the patient’s measure of “value” has become less important than the financial construct – or the value to the entities that manage the dollars, the government, the employer, and the health plan.