Health care has fallen into an ‘incentive paradox’ where the poorer the health of the population, the greater the provider reword is. The reason is that the driving incentive for providers is the volume of care. Meaning they maximize for patient number, and services utilized. The extreme conclusion to this logic implies, that health institutions will aim to have their patients sick enough to be treated, but no so much to be dead. These patients are chronically ill, suffering from diabetes, renal failure, high blood pressure, asthma, depression, etc.
The patient’s incentive to have a fulfilling and healthy life does not aline with those of the medical institution. So the question arises, how do we create new incentives, such as to have a future where hospitals are paid more when their patients are healthy, not sick. A shift from volume-driven to value-driven practice is needed. But first, we need to understand the meaning of value, how to measure and achieve it.
A value approach exceeds the diagnosis and treatment of illness, it includes the promotion of health, the integrated holistic treatment of disease and the prevention of illness. Reimbursement is done not only through the means of fee-for-service but providers are paid also based on patient health outcomes. There are various alternative payment models, but they all require that participant providers assume risk in different degrees.
Implementing such new models implies the measurement of new parameters and the analysis of complicated patters through the gathering of big data. Also, there is a need for a framework of information technology that enables people and processes with the end of coordinating and unifying patient care plans.
There seems to be a trend towards value-based care and many challenges remain, so we must remain vigilant for such emerging opportunities in the development of new technologies that allow for such models to develop and thrive.