Does your doctor want you to be healthy or sick? We all that know our doctor wants us to be healthy! Ironically, in America’s outdated health care system, doctors aren’t usually rewarded for such behavior. But what if they were incentivized to keep their patients healthy? That's the idea behind something called value-based care.
What Is Blue Buzz?
We know health care is complex and ever-changing, so let us break it down for you. Stay relevant by watching other videos in our Blue Buzz series.
Does your doctor want you to be healthy or sick? Well, we all know our doctor wants us to be healthy. But, in America's health care system, patients are stuck in an outdated, industrial model of health care. Physicians have to file claims to receive their income and as a patient's condition gets complicated, they may require more exams, more tests, more hospitalization.
With each service, more health care claims are filed. You get the picture. Clearly, this is a broken system. Some patients are run through the wringer for years, spending years bouncing from doctor to doctor racking up medical bills, all the while not getting the comprehensive care they need.
And of course, it's not the physician’s fault. Physicians truly care about their patients. But the current system is flawed. Through no fault of their own, doctors make more money when they submit more claims. This setup sometimes doesn't allow them to provide their patients with the most effective and cost- efficient care. But what if providers made more money the healthier their patients became? What if they were incentivized to keep their patients healthy?
That's the idea behind something called value-based care. It's a complete view of patient health that takes into consideration the patient's life outside the clinic. With value-based care physicians are paid based on how healthy their patient is. Instead of being paid by how many patients a practice sees, they're paid to provide the best possible care.
So, physicians are rewarded for providing quality care, and patients get the treatment they need, with fewer trips to the doctor, which saves them money in the long run too. Here's what this looks like in the real world. Frank has suffered from type 2 diabetes for 25 years. In the old system, Frank's doctor would help prescribe a treatment, but the underlying issues, the issues causing his diabetes, were never fully addressed. In a way, it's like Frank just got a series of Band-Aids. Very expensive Band-Aids.
But in a value-based care system, Frank's primary care physician would be inclined to dig deeper. Value-based care offers financial incentives for physician efforts that used to go unnoticed. Things like helping Frank control his A1c levels, talking to Frank's specialist regularly and getting their insight on his health.
Helping Frank lose weight so he can better control his blood sugar, gathering medical records related to Frank's exams or treatments.
All of that so at the end of the day, Frank jumps through fewer hoops and is able to receive the care he needed all along. Texans deserve a health care system that provides them with higher-quality care at a lower cost. We've been long overdue for a change.
SIGN IN to share your comments or REGISTER today to become a Connect member.
A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association© Copyright 2020 Health Care Service Corporation. All Rights Reserved.
Telligent is an operating division of Verint Americas, Inc., an independent company that provides and hosts an online community platform for blogging and access to social media for Blue Cross and Blue Shield of Texas.
File is in portable document format (PDF). To view this file, you may need to install a PDF reader program. Most PDF readers are a free download. One option is Adobe® Reader® which has a built-in screen reader. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com.