It has been very hard for me to wrap my brain around the new health care concept, Value Based Purchasing, VBP for short.
This isn't going to be a good explanation but if we're going to understand what is happening in the hospital treatment we receive we need to grasp the concept.
The Affordable Healthcare Act looked at the way healthcare is meted out in this country and said it was inefficient. There has been no accountability for outcome and the old "Pay For Service" model encouraged more visiits, tests and procedures. Value Based Purchasing would standardize care, create protocals of efficiency and ensure better overall healthcare.
A greater emphasis would be placed on prevention. Hospitals would be financially rewarded for improving results and reducing costs. They would be penalized for not meeting goals. A big part of making this new system work is analyzing patient experience which is done through post inpatient surveys and the electronic health record system. A satisfied, happy, and healed patient is worth more than a disgruntled, carping healed patient in the greater picture.
This isn't just all about being in the hospital. In fact, keeping the patient out of the hospital is a big goal. Faster turn around, releasing the patient sooner after procedures, is desirable. Shorter hospitalization time exposes the patient to fewer hospital infection sources and cuts costs. Alternatives to inpatient care are being created. Pilot programs for in home health care are in operation in some big cities. Shifting elder care from hospitals to nursing homes is being investigated. Virtual office visits, using Skype or Facetime, are likely to become part of healthcare.
CMS, Centers for Medicare and Medicaid, is the biggest force in instituting VBP right now but many employer sponsored healthcare prograns are following suit. The idea of healthier participants at a lower overhead appeals to not just government healthcare administrators but to private industry. VBP is not a proven system. It is a theory being brought into practice since the implementation of the Affordable Health Care Act of 2012. It is in response to the out of control increases in medical costs in this country over the past ten to twenty years. How well it works, whether it works at all, will determine what happens in the future.
I believe I am seeing the influence of VBP in my medical care in a small way. It seems to me that the frequency of seeing my doctors in routine follow up is changing. Doctors who used to ask me to return in four months now suggest that I come back in six months. A specialist I have been seeing for the past five years just told me I could be followed by my primary care physician and did not have to see her anymore. As a reverse total shoulder arthroplasty post surgical patient I was released from the hospital as quickly as I could have imagined possible, almost too fast. But as a readmitted sickie with a pneumothorax, to their credit, the hospital and staff went all out and there was no question of sending me home until I was totally ready and able.
Maybe this will work.
This isn't going to be a good explanation but if we're going to understand what is happening in the hospital treatment we receive we need to grasp the concept.
The Affordable Healthcare Act looked at the way healthcare is meted out in this country and said it was inefficient. There has been no accountability for outcome and the old "Pay For Service" model encouraged more visiits, tests and procedures. Value Based Purchasing would standardize care, create protocals of efficiency and ensure better overall healthcare.
A greater emphasis would be placed on prevention. Hospitals would be financially rewarded for improving results and reducing costs. They would be penalized for not meeting goals. A big part of making this new system work is analyzing patient experience which is done through post inpatient surveys and the electronic health record system. A satisfied, happy, and healed patient is worth more than a disgruntled, carping healed patient in the greater picture.
This isn't just all about being in the hospital. In fact, keeping the patient out of the hospital is a big goal. Faster turn around, releasing the patient sooner after procedures, is desirable. Shorter hospitalization time exposes the patient to fewer hospital infection sources and cuts costs. Alternatives to inpatient care are being created. Pilot programs for in home health care are in operation in some big cities. Shifting elder care from hospitals to nursing homes is being investigated. Virtual office visits, using Skype or Facetime, are likely to become part of healthcare.
CMS, Centers for Medicare and Medicaid, is the biggest force in instituting VBP right now but many employer sponsored healthcare prograns are following suit. The idea of healthier participants at a lower overhead appeals to not just government healthcare administrators but to private industry. VBP is not a proven system. It is a theory being brought into practice since the implementation of the Affordable Health Care Act of 2012. It is in response to the out of control increases in medical costs in this country over the past ten to twenty years. How well it works, whether it works at all, will determine what happens in the future.
I believe I am seeing the influence of VBP in my medical care in a small way. It seems to me that the frequency of seeing my doctors in routine follow up is changing. Doctors who used to ask me to return in four months now suggest that I come back in six months. A specialist I have been seeing for the past five years just told me I could be followed by my primary care physician and did not have to see her anymore. As a reverse total shoulder arthroplasty post surgical patient I was released from the hospital as quickly as I could have imagined possible, almost too fast. But as a readmitted sickie with a pneumothorax, to their credit, the hospital and staff went all out and there was no question of sending me home until I was totally ready and able.
Maybe this will work.
And now they recommend no more PSA tests and colonoscopy every ten years instead of the old five. Mammograms the same , that is, less frequent. Does not seem sane to me. Nor wise.
ReplyDeleteI fear lives will be lost unnecessarily due to these changes. Hate to be the guinea pigs!