HOW CAN WE MOVE FROM VOLUME TO VALUE?
By the very nature of health care’s design, primary care providers are dashed onto the rocks of volume-based care and blamed when we don’t deliver value-based outcomes. Is it any wonder why the more dedicated an individual physician is to patient centered care the more likely he or she is to burn out?
At the heart of this problem is payment:
- Family physicians get only 6-9% of health care dollars.
- Only 5% of health care spending goes to prevention practices that could keep patients out of expensive medical care.
- Only about 20% of care coordination and health coaching costs are covered.
It’s time to move from volume to value. This is something that the Veterans Health Administration is doing with its Whole Health program. Because they are a closed, or capitated system, they can make innovative changes that other systems can’t because they aren’t dragged down by regulation and insurance companies.
Over fourteen Centers of Excellence have been named to implement and test the Whole Health program with the goal of improving care for our nation’s veterans through integrative health care.
This summer I will be visiting several VA hospitals to see what we can learn from their exciting new programs and help bring them into the civilian sector.
As is often the case with innovation in health care, the military and VA are first out the gate with new efforts. Much of what we know about emergency medicine including the concept of triage came from the military health system. So did ultrasounds and blood transfusions. Now they are taking on chronic disease.
Hopefully, with lessons learned from the Whole Health Program, we can improve care nationwide for those with chronic conditions.