Based on her experience, Maria Lopes, MD, MS, explains that many large employers are adopting a value-based healthcare system. She notes that this may be because larger employers are focused on the long-term benefits of prevention and wellness.

Dr Lopes explains that while some employers offer incentives for meeting certain minimum criteria (eg, getting health risk appraisals), others incorporate value-based benefit designs. In some cases, employers punish employees with disincentives, such as increasing the employee share of the premium increases.

Yehuda Handelsman, MD, FACP, FACE, FNLA, explains that as a result of provider- focused pay-for-performance models of care, physicians may try to avoid treating certain higher-risk patient groups. Dr Handelsman explains that if a physician does not believe that an outcome of improvement for a patient or patient group is possible, there is no incentive to manage them. Jeffrey D. Dunn, PharmD, MBA, notes that most pay-for-performance models are incentive based.

Episode 14 - Value-Based Care-Can It Work?

During this segment, Peter Salgo, MD; Jeffrey D. Dunn, PharmD, MBA; Yehuda Handelsman, MD, FACP, FACE, FNLA; and Maria Lopes, MD, MS, analyze the pros and cons associated with the shift to value-based care and the pay-for-performance model.
Published Online: June 27, 2014
Based on her experience, Maria Lopes, MD, MS, explains that many large employers are adopting a value-based healthcare system. She notes that this may be because larger employers are focused on the long-term benefits of prevention and wellness.

Dr Lopes explains that while some employers offer incentives for meeting certain minimum criteria (eg, getting health risk appraisals), others incorporate value-based benefit designs. In some cases, employers punish employees with disincentives, such as increasing the employee share of the premium increases.

Yehuda Handelsman, MD, FACP, FACE, FNLA, explains that as a result of provider- focused pay-for-performance models of care, physicians may try to avoid treating certain higher-risk patient groups. Dr Handelsman explains that if a physician does not believe that an outcome of improvement for a patient or patient group is possible, there is no incentive to manage them. Jeffrey D. Dunn, PharmD, MBA, notes that most pay-for-performance models are incentive based.

View More From This Discussion
Episode 1 Episode 1 - Prevalence of Diabetes and Obesity in the United States
Episode 2 Episode 2 - Lifestyle Modification Programs-Do They Work?
Episode 3 Episode 3 - Barriers in the Treatment of Obesity
Episode 4 Episode 4 - Role of Pharmacotherapy in the Treatment of Obesity
Episode 5 Episode 5 - Recognizing and Addressing Factors Related to Nonadherence
Episode 6 Episode 6 - Pharmacotherapy Versus Bariatric Surgery
Episode 7 Episode 7 - Barriers When Managing Diabetes
Episode 8 Episode 8 - Changing the T2DM Treatment Paradigm
Episode 9 Episode 9 - Sodium Glucose Cotransporter 2 Inhibitors and Type 2 Diabetes Mellitus
Episode 10 Episode 10 - Additional Sodium Glucose Cotransporter 2 Inhibitors in the Pipeline
Episode 11 Episode 11 - Optimizing Outcomes in Type 2 Diabetes Mellitus
Episode 12 Episode 12 - Support for Patients With Diabetes
Episode 13 Episode 13 - Recognizing and Resolving Clinical Inertia
Episode 14 Episode 14 - Value-Based Care-Can It Work?
Episode 15 Episode 15 - Approaches to Managing the Diabetes Epidemic
Episode 16 Episode 16 - Closing Remarks
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