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Value-based care and care management

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Value-based care, as opposed to fee-for-service care, has been shown to improve the quality of care management, particularly for those patients with one or more chronic conditions. Those are the findings of a recent study conducted and published by Humana, the Value-based Care Report.

Worthe Holt Jr., M.D., M.M.M., Humana V.P., Office of the Chief Medical Officer, writes in the report that “By integrating care at all levels, we can better coordinate prevention and wellness of populations to slow and prevent the advancement of disease. We are rapidly moving from a focus on episodic care to one that addresses the whole person, inside and outside the clinical setting, by practicing value-based care.”

The study, Humana’s fifth annual, found that “Physicians who practice value-based care are achieving higher rates of patient engagement in preventive screenings, medication adherence and management of chronic conditions as measured by HEDIS (Healthcare Effectiveness Data and Information Set).”

Value-based care and care management are connected in that physicians are more focused on the need for preventive care and chronic condition management in a value-based care setting. They are better able to manage care for their patients, particularly those who may face challenges with social determinants of health, such as food insecurity or other socioeconomic factors, and who may also tend to experience more chronic conditions.

In fact, the report stated, that “on average, Americans with five or more chronic conditions spend 14 times more on health services than people with no chronic conditions.” Proper care management, including preventive care and medication management, that is part of a physician’s value-based care plan for the patient can catch these conditions early and enable the physician to properly treat the patient, keeping the patient healthier.

Roy A. Beveridge, M.D., Humana’s Chief Medical Officer, stated that “Practicing value-based care works to address the nation’s chronic disease epidemic by giving physicians the support and data they need to focus more on prevention and reduce acute care episodes. This model allows physicians to focus time and energy on those patients who need the most support to stay well at home, and out of the hospital. Physicians are clearly seeing the benefit of improved patient outcomes and more shared savings.”