How to Bring Value-Based Care Into the Exam Room

by Stephen Beeson, MD

Last year, I had the privilege of sitting down with Jennifer Main Rutberg, MD, HEC-C , Medical Director of Care Coordination at Banner Health, about the significance of value-based care within the confines of the exam room. There's a growing awareness of the importance of value-based care, particularly in enhancing patient outcomes and reducing healthcare costs.

However, despite this heightened awareness, notable progress in fully implementing value-based care practices remains elusive. Here are key insights from my conversation with Dr. Rutberg.

What is Value-Based Care?

In essence, value-based healthcare entails a model where healthcare providers receive compensation based on patient health outcomes. This model incentivizes clinicians and organizations to focus on improving patient health, reducing chronic disease impacts, and promoting evidence-based, healthy living practices.

Despite the growing momentum behind value-based care, the fee-for-service model remains dominant in American healthcare delivery and payment systems. While incremental progress towards value-based care is evident, substantial shifts are still underway.

The Progress of Value-Based Care

Dr. Rutberg highlighted significant progress in adopting value-based reimbursement models among physicians. According to the Health Care Payment Learning and Action Network , 60% of health care payments in 2020 included some form of quality and value component. Similarly, in a survey by the American Academy of Family Physicians , 49% of respondents said they are participating in some form of value-based payment.

However, despite this progress, the healthcare expenditure in the United States continues to soar, with healthcare spending increasing annually. Although there is a general consensus among healthcare professionals on the importance of value-based care, its adoption and integration remain challenging.

Value-Based Care and the Individual Clinician

During our conversation, Dr. Rutberg and I highlighted the critical role of individual clinicians in implementing value-based care principles within the exam room. Value-based care transcends mere policy directives; it necessitates a fundamental shift towards proactive, evidence-based, patient-centered care.

Key to this transition is the identification of patient goals as the context for care recommendations. By focusing on what matters most to patients, clinicians can tailor care plans to align with patient objectives, thus facilitating engagement and adherence to clinical recommendations.

So often, the answer is in the patient’s story. What we do in the exam room is we ask questions and we listen; we build relationships and we build trust. That is our high power tool to bring value to patients. – Jennifer Main Rutberg, MD

Additionally, involving the entire healthcare team in patient care is essential. Team-based care, coupled with a proactive mindset and focus on social determinants of health, lays the groundwork for delivering high-value care that benefits patients, organizations, and communities alike.

It's no secret that value-based care represents a transformative shift in healthcare delivery, requiring a concerted effort from clinicians, teams, and organizations. By embracing the principles of value-based care, healthcare providers can ensure better outcomes for patients while addressing the systemic challenges within the healthcare landscape.

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