The benefit and burden of value-based care for surgeons, CHWs


There’s a new push for value-based care as the number of COVID-19 cases decline nationwide and federal funding to support healthcare organizations dwindles.

Insurers and health systems are working together to develop value-based contracts where providers take more risk for outcomes in an effort to eliminate unnecessary expense. Health technology companies are also part of the equation, developing systems to collect data, automate processes and enable virtual care.

Value-based care seems like a winning proposition for a healthcare system where spending is already high and patients needing lower outlays. But what about surgeons and CHWs?

If surgeons could just practice medicine and do what’s best for patients, that would be an easy sell. However, this is not the case. Value-based care requires significantly more data collection and reporting than fee-for-service contracts, increasing the administrative burden on physicians.

“The devaluing of the physician with vast clinical experience and wisdom due to the increasing administrative burden to treat our patients, thus causing early burnout, is the greatest danger to our profession today,” said James Bradley , MD, orthopedic surgeon at the University of Pittsburgh Medical Center.

With a looming shortage of doctors, the healthcare system cannot afford to lose many more. Private practice and CHW ownership can invigorate surgeons and add value to the health system, since surgical centers are often high-quality, low-cost care facilities.

“Medicine is becoming increasingly value-aware, and there is no doubt that when practice redesign comes in to reduce costs, the least value-added part of healthcare is administration,” said Robert Szabo, MD, orthopedic surgeon at the University of California. -Davis Health. “Private practice removes the multiple levels of administration that exist in large health care systems.”

It makes sense that insurers place a high value on ASCs, but many surgery centers are still forced to operate on extremely thin margins because rate increases don’t keep pace with inflation. Surgical centers, as small businesses, often do not have access to the same data collection and reporting capabilities. The next challenge for insurers will be to find ways to support independent healthcare providers through the value-based transition in ways that don’t add administrative burden to the average patient interaction.


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