Ed: The path towards value-based care is fraught but IT expert Rafic Habib is among the many who see it essential to overcome future healthcare dilemmas. 

Rafic Habib is The CEO and Chairman of Clinic to Cloud a cloud-based practice management software provider.

Rafic Habib is The CEO and Chairman of Clinic to Cloud a cloud-based practice management software provider.

Age has been a battleground long fought in the quest to beat ageing. The advancement of medicine, quality of life and lifestyle have created an unusual paradox between longevity and the despair of getting older.

Australia’s ageing population as it continues to grow, places demands on the demographics of an economy where the health system is stretched to cope with what getting old creates.

Michael E. Porter’s, Redefining Health Care calls it a “Zero-sum competition in health care”. His interpretation of the lack of competition in a sector such as health reduces our ability to maximise value. Porter writes, “…value-based competition will not only lead to more patients being cared for by excellent providers, but also inspire and drive innovation in medical care”.

Simply, ageing is becoming overwhelming for Australia.

The need for an efficient healthcare system requires agile creative thinking, making value-based care a new paradigm of engagement.

If value-based care is to produce the benefits it promises, then two important requirements are critical from an Electronic Medical Record platform – patient engagement through portals and information at the point of care for clinicians with mobility and effective good reporting.

And yet, with pressure to change from insurers and government, the emphasis of our healthcare system to enhance key outcomes, lower budgets and grow general access, we are strategically shifting away from a fee-for-service model.

Moving towards value-based care, patient outcomes, reducing hospital readmissions, advanced health IT systems, improving preventative care, and a reimbursement plan, are vital cogs in a compelling argument for healthcare providers to deliver better care initiatives.

The demand from public and commercial forces to reduce costs and improve healthcare delivery is pushing people away from volume-based healthcare to value-based healthcare, aiming to adjust payment and objective measures of quality medical care.

Implementing value-based care reimburses providers, helps patients take control of their health, diminishes incidence of chronic diseases and allows people to live better lives thereby easing the national healthcare burden.

So why isn’t value-based healthcare in play? The answer lies with the technology required to engage patients in order to measure outcomes. Patient portals and apps are required to drive feedback that will track and analyse to understand the value provided.

Value-based care aims to establish practices where prevention is paramount, along with initiatives that guard an individual’s health via programs reducing the need for expensive tests and medicines.

A number of medical and healthcare providers already participate in a value-based healthcare model. The payment process encompassing doctors, hospitals and other providers is forged on a different measurement tool which includes quality, effectiveness and cost-enhancing patient experience.

Shifting toward a value-based model is driven by market pressures to reduce costs and improve the quality of healthcare. Government, employers, healthcare plans and consumers need to work together to deliver on value.

Value-based healthcare looks to ensure:

  • Patients remain the focus of healthcare and are supported by a specialised care team;
  • Proactive care, treatment and medication is delivered;
  • Patient data provides enhanced care and management;
  • Value is the benchmark for private health insurers and pay is centred on quality of care;
  • Patient quality engagement rises in standard when the shift is away from volume to value.

Transitioning from fee-to-service to value-based care will take time to implement, but in any paradigm shift, change always produces hurdles before there is a clear run to the straight.

Healthcare providers strive with dedication and care to help patients in all aspects of health management and recovery. Putting aside strategies to support a value-based model, conducting strong patient outreach programs are equally important.

Offering positive experiences through the use of innovative technology will help deliver quality healthcare at a lower cost and it is critical to the viability of a successful value-based care model.