Are you getting the full value of practicing medicine?
Like patients pursuing their optimal wellness, the value-based care transformation at Optum hasn’t happened overnight. Born from our mission to make a health system that works better for everyone, we’ve carefully adapted and fine-tuned our care system, creating a better overall care experience by emphasizing quality, not quantity. The changes, as you’ll see below, are resulting in better outcomes, more sustainable practices and higher overall satisfaction from patients and physicians.
The valuable outcomes of value-based care
Kenneth Cohen, MD, FACP, executive director of translational research for Optum Health, co-authored an important study, Comparison of Care Quality Metrics in 2-Sided Risk Medicare Advantage vs. Fee-for-Service Medicare Programs, which was published in JAMA Network Open.
The research highlights the positive implications of value-based care. Dr. Cohen states, “We’ve seen some studies that demonstrate better outcomes in value-based models, but this is the first comparison with fee-for-service (FFS), which is critical because it shows a clear rationale for moving to a model rooted in delivering high-value, appropriate care.”
The research in the report was conducted by analyzing and comparing results from over 316,000 people who were evenly split into either an FFS or a value-based program. The results between the two segments showed higher-quality outcomes for people under care programs at Optum using our unique approach to value-based care — particularly those receiving treatment for chronic obstructive pulmonary disease (COPD), stroke and myocardial infarction.
Highlights from the report:
- 44% lower rate of hospital admission for COPD
- 14% lower probability for avoidable emergency department (ED) visits
- 18% lower rate of inpatient admission
- 10% lower chance for stroke and myocardial infarction
- 9% lower likelihood of 30-day readmission
Better care, informed by data
The key to the value-based care approach at Optum is the utilization of data and analytics. Optum physicians have evidence-based tools at their fingertips that allow them to deliver the right care at the right time for their patients. And with 90% of patients in value-based care participating in annual wellness visits as part of the program, clinicians are able to prioritize predictive preventive measures such as immunizations, screenings, lifestyle changes and disease management protocols to help patients avoid hospital or ED visits.
With regular patient touch points and connected data, value-based care physicians at Optum can guide patients toward the best treatments for their conditions and even help them find lower-cost yet highly effective prescriptions. Data has a unique power to unite the patient and doctor with a clear vision on how to move forward with care. With a more predictive and informed approach to medicine, physicians can access quality performance data, which enables them to identify at-risk markers with greater ease — and even be more discerning in guiding patients to referring specialists, selecting those who consistently deliver high-quality care.
Looking forward to 2030, when the Centers for Medicare & Medicaid Services (CMS) plans to have 100% of Medicare reimbursements tied to value, Optum is uniquely positioned to be ahead of the curve. Being early adopters of value-based care, we’ve been building our practices to deliver quality care — care that is holistic, personal, collaborative and rewarding.
The benefits of value-based care can be seen in patient outcomes and practice performance:
Improved patient outcomes
• Improved accessibility to care
• Enhanced coordination between care providers
• More time with providers, resulting in more comprehensive care plans
• Improved outcomes, patient experience and overall quality
Across Optum, we’re seeing how our team approach to value-based care is changing our capabilities, improving our outcomes and increasing clinician satisfaction. With our strong teams, advanced data, integrated resources and extensive support we’re creating an integrated network that is making health care work better for everyone.
To learn more about the benefits of practicing at an Optum value-based care practice, visit https://Optum.Co/Value
