There’s No Accountable Care without Accountability: The Imperative Transformation to Value-Based Healthcare

In the complex world of healthcare, the concept of value-based care (VBC) has inspired hope, promising outcomes-driven care at a lower cost and delivering a concierge-level experience for all. The need for this transformative shift is evident in the myriad challenges plaguing our current services and volume-driven, fee-for-service healthcare framework.

Contrary to the existing system, riddled with complexities and inefficiencies, value-based care represents an opportunity to help drive a revolution in patient outcomes, eliminate care team friction and reduce the total cost of care.

This vision for a “Quadruple Aim”-aligned ecosystem –– including provider health in the Triple Aim of population health, cost reduction and patient experience – is achievable provided key technological implementations and more than anything, a shift in the collective mindset toward a novel concept in healthcare, accountability. In a world where one of the best integrated health systems in the US, using one of the most well-regarded EHRs, drops the ball 58% of the time*, something is clearly amiss.?

While best intentions and Hippocratic oaths rule the driving force behind managing care responsibilities on behalf of patients, a volume-driven, administratively burdensome environment has made this impossible. The critical missing piece as we seek to scale the laudable goals for VBC is accountability, knowing who is responsible for what, by when and providing clarity across the care continuum for every single patient and population.

There is no hope for truly accountable care without accountability and our current toolset is incapable of providing it across a patient’s care journey and care team.

The Broken Healthcare System: A Critical Analysis

Our healthcare system, anchored in a fee-for-service model, faces inherent challenges that ripple across patient care, provider burnout, a staffing crisis and financial strains. While solutions have traditionally focused on the patient, the neglect of enabling the care team exacerbates problems. As a once-burnt-out physician myself, I deeply believe in the importance of 'putting one's oxygen mask on first.'

The data and real-world examples, particularly in a post-Covid world underline the inefficiencies of the current system, leading to dropped balls, staff overwhelm, preventable medical errors, and an overwhelming financial burden on patients, providers, and payers. The urgency for change becomes paramount as we witness the toll it has taken on both the health of individuals and the sustainability of our healthcare infrastructure.

The Fintech Change-Management Story: Relevant for Healthcare?

Drawing parallels with the transformation of the financial industry through fintech, we find a recent proxy for healthcare's evolution. The old pain points in banking – high fees, limited accessibility, and inadequate customer service – were transformed by technology, leading to branchless institutions, self-service customer care, and a customer-centric approach.

Similar pain points exist in healthcare, from outdated processes to fragmented communication. Imagine replacing paperwork with streamlined technology, enabling efficient communication, and placing a renewed emphasis on both patient and care team satisfaction. The healthcare industry, like finance, is ripe for a technological revolution.

Steps Toward a Value-Based Future

To usher in a value-based future, the healthcare industry must undergo a systematic transformation. This includes the adoption of outside technology partners to accelerate the process in organizations facing destabilized workforces. These partners offer products and services that can deliver value-based care embedded seamlessly in frontline operations and are responsive to the financial model that underpins VBC.

Additionally, collaboration among distributed and siloed care team members is essential.

We must move beyond the inbox to a more accountable system where patients can rely on their care teams and healthcare workers aren’t drowning in the junkmail and SPAM equivalent in their EHRs.

If value and population-level health is truly what we seek, we must all contribute as it is within reach and essential. First, the culture and leadership’s resistance to change needs to give way to acceptance and the technology needs to move forward, embracing innovations from which every other industry has benefited.

Overcoming Challenges

Acknowledging skepticism and resistance within the healthcare industry is crucial. Evidence supporting the feasibility and benefits of health-tech platforms dispels doubts, demonstrating how these solutions stabilize workforces, increase practice efficiency, and instill accountability – the heart of value-based care.

As urgency mounts for a healthcare transformation, akin to the financial industry's technological revolution, the call for collective action and collaboration echoes through the healthcare ecosystem. Value-based care is not a distant dream or luxury, but an achievable reality with the right tools, platforms and the incredible people who make healthcare happen.

*Kaiser, AKJD; Am J Kidney Dis. 74(5): 589-600. Published online July 16, 2019.