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Value-based care has gotten a lot of attention in the health care industry over the past 10 years, but the truth is, it has not succeeded in what it was intended to do at scale. In fact, research shows that value-based care models have not lowered costs or improved patient outcomes at scale. Individual contributions to health care expenses have continued to rise without signs of slowing. And over the past decade, the gap in mortality between the US and similar nations has widened and disease burden has worsened.
This all begs the question: Why isn’t value-based care having the intended effect across the industry? The fundamental tenets of value-based care still hold promise. We have seen some areas where it’s working, like in acute or specialty care. For example, in areas where there’s a focused population like in end-stage kidney disease and oncology, organizations are using focused analytics and care coordination tactics to address avoidable spend holistically.