Value-Based Care

       Sustainable Healthcare Models

An ideal high-value health care system features six key components: a clear, shared vision with the patient at the center; leadership and professionalism of health care workers; a robust IT infrastructure; broad access to care; and payment models that reward quality improvement over volume.

Under a value-based healthcare model, healthcare providers (including hospitals and physicians) are compensated based on patient health outcomes.

Healthcare is in a period of dramatic change, and organizations are looking to position themselves as value-based enterprises. 

The transformation of our healthcare delivery system continues to progress, and healthcare providers are constantly being asked to evaluate new delivery models for relevance, replicability, and fit.

ACCOUNTABLE CARE ORGANIZATIONS

An ACO is any healthcare organization that assumes financial accountability for the overall value, in terms of cost and quality, of care delivered to the population of patients/beneficiaries the organization’s providers serve.

Depending on how they are reimbursed, other transformative healthcare delivery models can be appropriately labeled as ACOs, including clinically integrated networks (CINs), select patient-centered medical homes (PCMHs), and population health service organizations (PHSOs).

2

CLINICALLY INTEGRATED NETWORK

While ACOs may be the most popular topic related to care model transformation, CINs rank a close second. The most notable characteristic of ACOs is the way in which they are reimbursed; however, CINs are primarily defined by the manner in which care is provided within the clinical delivery system. In the most general terms, a CIN is any group of providers that has effectively coordinated the clinical services provided to their patients across the care continuum.

3

PATIENT-CENTERED MEDICAL HOME

“Patient-centered” refers to the model’s focus on understanding the comprehensive healthcare needs of each patient, involving patients in care plan development, and engaging patients in the management of their own health. “Medical home” relates to the model’s emphasis on the establishment of a deep relationship with a primary healthcare provider (and the care team embedded in that provider’s practice) who will be responsible for coordinating all of the healthcare services required by the patient.

4

POPULATION HEALTH SERVICE ORGANIZATION

Technically, a PHSO is any organization that provides the resources and programs to deliver rule-based care to effectively and efficiently manage the health of patient populations.

As the PHSO’s name implies, the model’s sole focus is the provision of population health services (e.g., engagement, outreach, education, care coordination, chronic disease management, complex case management). 

Businessmen

Let's Work Together

National Health Services is committed to service care models that transform healthcare into a more sustainable future.