Fee-for-service care is not really in line with how primary care physicians think or how primary care should be delivered; the crux of value-based care is wanting patients to have the care they want and need, noted Kristin Oaks, DO, Agilon regional medical director at Central Ohio Primary Care.
Fee-for-service care is not really in line with how primary care physicians think or how primary care should be delivered; the crux of value-bsed care is wanting patients to have the care they want and need, noted Kristin Oaks, DO, Agilon regional medical director at Central Ohio Primary Care.
Oaks spoke at our recent Institute for Value-Based Medicine® event held in partnership with Zangmeister Cancer Center in Columbus, Ohio.
How does value-based care in primary care compare with traditional fee-for-service models?
One thing I think about primary care in general, part of it is, as primary care physicians, the reason we chose primary care is because we like this sort of longitudinal care relationship over time—the idea that we affect patients’ care over time—and fee-for-service doesn't really lend itself to that very well. In fee-for-service, the more you do, the more you make, and that is not necessarily in line with how primary care physicians think or how primary care should be delivered. So let's start with that the different payment model supports primary care in a better way.
Other outcomes that you see, I really think about it in terms of how we can help to eliminate waste. I think about waste as underutilization of care that improves patient outcomes and elimination of overutilization of care that doesn't improve patient outcomes. I think that's kind of the approach from primary care: You have this panel of patients, you know who your patients are, you know what's wrong with them because you've had those high-visibility visits with them, and then you can work to eliminate waste from either side, under and overutilization.
What are primary takeaways to embracing value-based care in primary care?
I think the primary takeaway is that when you eliminate waste, you make a better experience for patients, because waste in health care is synonymous not with harm but with patient experience, right? No one wants to spend an additional night in the hospital, no one wants to go to the emergency room, no one wants to have any kind of iatrogenic incidental issue. We really want patients to have the care that they want and the care they need. And that's really the crux of value-based care.