This is an analysis of value-based care approaches that meet the current and future needs of patient care delivery.
Identify at least three approaches that meet the current and future needs of patient care.
How do these approaches meet the needs of current and future patient care. Be specific in this explanation.
Future Needs (Outcome Focus & Predictability): By shifting risk to the provider for the full episode, the focus moves from volume (how many services) to outcomes (successful recovery, no readmission). This aligns with the future need for a healthcare system that rewards successful, complication-free care. It also provides greater cost predictability for payers and patients for common procedures.
Description: PHM is a strategic approach to improve the health outcomes of a defined group of individuals (a population) through data-driven initiatives, care coordination, and targeted interventions. It often addresses health needs beyond the clinic, including social determinants of health.
Current Needs (Chronic Disease & Prevention): It actively identifies and manages patients with chronic conditions or those at high risk (e.g., via risk stratification) using data from various sources (EHRs, claims, SDoH data). This allows for proactive and preventive care—like outreach for screenings or medication management—to prevent costly acute episodes, a critical need given the high prevalence of chronic diseases today.
Description: Bundled payments provide a single, fixed payment to providers for all the services a patient receives during a defined "episode of care," such as a knee replacement or a heart attack. This payment covers services from multiple providers and settings (e.g., hospital stay, physician services, post-acute care).
Current Needs (Care Coordination & Efficiency): They incentivize care coordination among different providers (hospitals, surgeons, physical therapists) who are now financially linked to the same episode of care. This reduces redundant tests or services and encourages providers to use the most efficient and high-quality settings (e.g., home health instead of costly skilled nursing facilities) to stay under the fixed price, directly addressing the current problem of fragmented and high-cost care.
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