More Than Money: If We Keep the Mission of Value-Based Care Front and Center, the Math Will Work

This perspective was shared by Wildflower's founder and CEO, Leah Sparks. 

We all know that the fee-for-service model in healthcare is unsustainable. It’s clear that our current maternal health performance is unacceptable. And the gaps that exist in health equity? Unfathomable.  

Value-based care is being applauded as the cure for what ails our system. It’s easy to reach consensus when we think about this new utopia, where the system aligns around providers and their patients to create high-quality, low-cost care that is made equally available to all healthcare consumers.

But when we start unpacking the “how” and start talking about who pays for what, things start to fall apart, and we get stuck. It’s naïve to say that money doesn’t matter. Of course it does. The math has to work. But with value-based care, it’s really easy to let the financial models distract us from our primary goal, which believe it or not isn’t about the money.

Isn’t the hope of value-based care to create true value, not just to put a price squeeze on providers?  Early efforts in the value arena were focused on “steerage to the lowest cost facility” vs really addressing underlying clinical factors and helping providers practice at the top of their license.  The latest iteration of value-based care is much more about supporting the patient holistically and forming a relational bond between the provider and the patient. At least that should be what it’s all about. 

But we are all taught to follow the money. In healthcare, there is a long list of perverse incentives we have to unwind. And in the short-term, transitioning to value-based care includes the possibility that stakeholders will make less money than they did before. Even so, there is low-hanging fruit that will allow us to minimize short-term deficits on the way to value-based care. And ultimately, when we reduce low-value care and focus on the whole patient, providers will actually be more profitable per patient under a value-based model than a traditional FFS model. 

In a recent edition of the “How I Built This” podcast from NPR, filmmaker M. Night Shyamalan had this to say about “making money.” He said that the money will come when you “create a strong connection with your audience.” Shyamalan’s well-documented success proves that his approach works. Do the right thing for the end user, and profit will follow. Lots of profit. 

This isn’t just true for Hollywood. It’s true for healthcare. 

I know I’m not the first person to say it, but focusing on the patient leads us to the promised land. Truly focusing on what is best for the individual, putting people at the center, is the most powerful force we can use to heal our system. But I think part of what’s been holding us back is that we need a reason to believe.

This jump from FFS to VBC might seem scary to some, but it doesn’t have to be. At the end of the day, we must truly, deeply, fully believe that if we do the right thing for the patient that financial success will follow. I believe that organizations who embrace the promise of value-based care and take that leap will be handsomely, and appropriately, rewarded in the long-run. Those who half-heartedly go along for the ride, or sit by and watch the show, will find themselves on the wrong side of a seismic shift. 

I was listening to a Ted Talk the other day, and the following quote stopped me in my tracks. A medical student was being interviewed, and she said…

“I want to be the doctor that remembers when your birthday is without having to look at the chart. And I want to be the doctor who knows what my patient's favorite color is and what TV shows they like to watch. I want to be the doctor that's remembered for listening to people and making sure I take care of all of them and not just treating their disease.”

I want to help her be that doctor.  I want her to be my doctor. I want all clinicians to have the freedom, the power and the resources to deliver this type of personalized, relationship-based, holistic, care. That’s what the purpose of value-based care is. That’s what will bring future rewards to all healthcare stakeholders.

So, once again. It can’t be about the money. Let’s create a strong connection with our patients and deliver the care they deserve. The math will work if we don’t lose sight of the mission.