Excerpt from the April 2020 article in The Actuary magazine.
The Society of Actuaries (SOA) series on value-based care (VBC) is exclusively available online. The first in the series of articles introduces the concept and provides the framework for two subsequent articles.
Note: This information is not meant to be all-encompassing. Nor should you interpret it to pertain only to a provider actuary or a provider.
In many instances, the information can be applied broadly. It is, however, meant to provide a deeper understanding from this single perspective.
VBC defined
A single definition for VBC has been elusive. It continues to evolve and the definitions can vary depending on the stakeholder point of view.
Instead of trying to create a single definition to describe VBC, it may be easier to describe it as an ideal with ambitious objectives. It's most analogous to the Triple Aim, representing improving the patient experience, reducing per capita medical spend and improving the population’s health.
These objectives are universal in nature and widely accepted by all health care stakeholders.
Applying this description to VBC provides a broad background to explore the various interrelated components necessary to achieve these objectives. These include:
- Payment reform
- Provider and member engagement
- Population health management
- Advanced analytics
- Interoperability
- Systems integration
- High-performance networks
- Partnership models
- And more
These activities, when executed at a high level and in combination with each other, will create value to the various stakeholders within the health care ecosystem. They include consumers, purchasers, payers, providers, etc. In this series of articles, we will take a closer look at VBC.
Click here to read the rest of the article by Jay Hazelrigs. This first appeared in the April 2020 issue of The Actuary magazine.
