Value-Based Purchasing (VBP)

What is Value-Based Purchasing (VBP)?

In healthcare, value-based purchasing is the ultimate attempt at linking healthcare payments to improvements in the patient’s individual care. It attempts to reduce the amount of care given for the profit alone and also to greatly reward the best-performing healthcare providers. Home health value based purchasing also keeps home healthcare accountable.

Hospital Value-Based Purchasing

Hospital value-based Purchasing works by rewarding the quality of clinical care provided to Medicare patients. This includes the treatment of the patient during the extent of their stay and how closely good practices were followed. This includes whether they perform better than the competition and how much it has improved since the baseline period. The baseline is the data that was collected before the patient’s treatment began. Hospital value-based purchasing measures on everything from the conscientiousness of safety to the level of patient-centeredness that the care was conducted on.

Home Health Value-Based Purchasing

Home health value-based purchasing is more or less self-explanatory. It is for patients on Medicare who receive health services in their home. For example, an elderly patient living at home who needs a nurse or other caregiver to come to their homes to help them manage and organize their medications, change their catheters, provide ostomy care, etc. With more of the elderly population trying to stay at home for as long as possible as opposed to going into nursing care, home health value purchasing has become an increasing necessity to help maintain the healthcare that they actually need. Most of them are on Medicare and can’t afford to shell out more money for healthcare tests, etc. that they don’t really need. As a result, home health value based purchasing can be very beneficial to both the patient and their care providers.

Pros And Cons of Value-Based Purchasing

As with almost anything in this world, there are certain benefits and drawbacks for value-based purchasing. While the benefits may heavily outweigh the cons for most people, here's a deeper look into both sides of value-based purchasing.

Pros Value-Based Purchasing

  • Patients have the right to hold their care providers accountable for not only the quality of services but also the cost. Value-based purchasing is designed to improve the quality of care overall and to cut down on the number of lawsuits due to poor quality and costs. It is hoping to motivate care providers to do only their best on the job. This also means reducing the discrepancies in allowable charges and more lower deductibles.
  • Even though patient satisfaction alone is not necessarily a sign that the company provides satisfactory care, it is a good sign that care providers are becoming more sensitive to what the patients actually need. Healthcare research has been catching up to the fact that the lack of incentive not preventing high volumes of tests, etc. that the patient does not really need. -reduction in other medical errors. Research has also been catching up to the fact that a majority of clinical funds have, unfortunately, been going towards ineffective and even harmful resources. Value-based purchasing is aimed at improving this and more.
  • Aside from rewarding care providers who provide the best care, value-based purchasing also aims at other proactive measures such as awareness and prevention of illnesses. They also capitalize on financial rewards for such successful coordination.
  • Employers can adjust their benefits packages according to their insurers’ recommendations. Employees also get rewarded for things like smoking cessation and weight loss, which promotes healthy living habits.

Cons Value-Based Purchasing

  • Holding care providers accountable for the wrong services and completely missing the services that they did provide.
  • Complex cases may still be difficult especially on hospital value-based purchasing and home health value-based purchasing. It poses a certain risk that care providers will be penalized for caring for such cases and providing evidence-based services.
  • Risk of misleading patients as to which care providers provide lower cost services.
  • Risk of failing to provide the actionable information that cares providers need in order to keep improving their services.