Value-Based Care, part 2

As a patient, you might not see the immediate need to shift from the fee-for-service model to Value-Based Care, especially if your healthcare benefits are fully covered by your employer as in the case of about 55% of Americans. However, there are two reasons why this transition is beneficial for you.

Proactive Health Management

The fee-for-service model may seem convenient, but it overlooks a crucial aspect of healthcare: prevention. Hospitals and healthcare providers operating under this model may not prioritize your long-term health. Instead, their focus might be on the quantity of services provided, not the quality.

Consider this: you’re fully insured and visit a hospital for a routine check-up. The hospital suggests additional tests — not because you need them, but because each service adds to their revenue. Your time and well-being become secondary to the hospital’s financial gain.

Financial Incentives for Wellness

It may sound harsh, but in a fee-for-service model, there’s little financial motivation for providers to keep you healthy. The more services they render, the more they earn. This misalignment of goals can lead to situations like the following one. A Ukrainian refugee friend of mine, now in the U.S., experienced this firsthand. He visited a dentist for a severe toothache, expecting a standard procedure. The dentist, however, saw an opportunity to maximize profit under the guise of treatment, suggesting the removal of three teeth instead of the problematic one. Fortunately, my friend realized the overreach in time and prevented unnecessary extractions.

This story, while shocking, isn’t unique. It’s a symptom of a system that incentivizes over-treatment. We need a model that aligns the financial interests of doctors with the health outcomes of patients.

Under the value-based care model, the focus shifts from ‘how many patients we can see’ to ‘how well we can treat each patient.’ Patients benefit from a healthcare system that values their health above all. For doctors, VBC can reduce burnout by allowing them to focus on fewer, more meaningful patient interactions. It’s a win-win: healthier patients and fulfilled healthcare professionals.

In conclusion, even if you’re fully covered by your employer, VBC is in your best interest. It ensures that medical personnel work diligently to maintain your health, not just treat your illnesses.