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Recently, I’ve become uncomfortable with the buzzword of health care reform in our time: “value-based care.” We’ll look closely at that term in this article and sketch out some paths forward to something better.
Some context: During the 15 years that I’ve been covering health care IT, commonplace terminology has been repeatedly re-examined. The terms chosen by clinicians and payers say a lot about biases and assumptions, and the field has seen many shifts with the goal of educating us to be more sensitive. (The terms “No-show” and “non-compliance” are on the outs, for instance.)
Value-based care, and the earlier phrase “fee-for-value” it seems to have replaced, are monikers for a commendable and crucial movement to meet the patients where they are, with the hope of significant gains in treating chronic conditions. But the word “value” indicates we’re still more concerned with the payer’s point of view than the health of the patient.
So what difference does it make to shift from value-based care to my suggested replacement, patient-centered care? Is this like so many putatively progressive initiatives that just shuttle from one euphemism to another? Not if we think about its implications.