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For years we’ve been promised the Emerald City of the U.S. healthcare – a value-based care model. And for good reason. The volume-based fee-for-service care approach we have now is the most expensive in the world and among the worst in quality.
We spend 20% of the country’s GDP on healthcare at an average cost of nearly $12,000 per person annually. That’s roughly double compared to other high-income countries. Despite this expenditure, the U.S. ranks dead last compared to peers across performance indicators like access to care and healthcare outcomes.
The yellow brick road to a better system, VBC, was supposed to supplant fee-per-service with rewards for better overall health outcomes. We would improve population health, reduce per capita healthcare costs and provide better experiences for patients.
Since the Medicare Improvements for Patients & Providers Act (MIPPA) of 2008, the Affordable Care Act (ACA) of 2010, and through multiple efforts since, providers have been told that change is on the way, that the Emerald City would come. Yet almost 15 years later less than 7% of primary care providers get paid through VBC models.
So far, the promise of VBC has only increased the burden on providers. Of the $4 trillion spent on healthcare every year in America, about a quarter of that — almost $1 trillion — is spent on administrative costs.
Yet there’s hope. Providers can make real progress towards value-based care systems with these approaches…