Value-based care has been held out as a panacea for all that ails US healthcare. A closer look reveals that its front-line reality might not be as rosy as we might hope.
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These observations arise from my time as an academic studying value-based care; my leadership of CareMore and Aspire Health, the value-based care delivery divisions of Anthem Inc; and my current role leadingAnti-Hospital? In addition, many value-based care groups prioritize palliative care and proactively transition patients to hospice—in part, because it’s often the right thing to do, and in part because patients with end-stage conditions often get admitted to the hospital and utilize countless expensive hospital bed days.
In addition, some patients find that small, carefully curated specialist networks subject them to significant, potentially harmful delays in accessing care.Again, seeking to reduce costs, many value-based care groups often introduce new types of clinicians in the care of patients.
Value-based care groups can quickly find themselves at odds with their patients when their recommendations and treatment plans contradict what patients themselves learn doing their own research on the best and most modern course of action for their condition.Many groups that are “value-based” assume full responsibility for the total cost of care.
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