{"id":775,"date":"2018-03-23T19:21:30","date_gmt":"2018-03-23T19:21:30","guid":{"rendered":"http:\/\/depts.washington.edu\/uwmedptn\/?page_id=775"},"modified":"2025-08-01T21:51:24","modified_gmt":"2025-08-01T21:51:24","slug":"value-based-care","status":"publish","type":"page","link":"https:\/\/depts.washington.edu\/uwmedptn\/strategies-programs\/population-health\/care-management\/value-based-care\/","title":{"rendered":"Value Based Care"},"content":{"rendered":"

Overview<\/h2>\n

What is Value Based Care?<\/strong><\/h3>\n

Value-based care is a care delivery model that prioritizes patient outcomes\u00a0in the way that health providers are reimbursed. In this payment system, physicians and hospitals are rewarded for improvements to their patients health\u00a0within a reporting\u00a0period, including reductions to the effects and incidence of chronic disease and\u00a0adherence to preventative care. In 2016, the Department of Health & Human Services (HHS) has set a goal of converting 50% of traditional fee-for-service Medicare payments to value-based payment models by the end of 2018. Since then, several commercial insurers have been moving in the same direction.<\/p>\n

The value-based\u00a0model\u00a0places more\u00a0‘value’ on preventive care, to keep people healthy and prevent hospital admissions and ED visits. In a value-based care model, providers aim to achieve certain quality goals for a given population of patients at a pre-determined cost. Most value-based contracts include various quality metrics, to which physicians and hospitals are measured – and paid – in order to provide better quality care for patients with better outcomes.<\/p>\n

What are HEDIS quality measures?<\/h3>\n

HEDIS stands for Healthcare Effectiveness Data and Information Set. HEDIS is a set of STANDARDIZED quality measures. This standardization helps the public compare the performance of organizations across the nation. The NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA) coordinates and administers the program. HEDIS 2018 (2017) specifications include 95 measures across seven domains of care.\u00a0 HEDIS measures focus on prevention, screening, conditions across all body systems, access to care, satisfaction with care, as well as utilization of specific procedures and care settings.\u00a0 According to the NCQA, \u201cHEDIS measures and specifications are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications.\u201d<\/p>\n

Some value-based contracts at UW Medicine:<\/p>\n

Premera:<\/h3>\n
\n

GOC<\/p>\n<\/blockquote>\n

Regence:<\/h3>\n
\n

UW Medicine AHN<\/a><\/p>\n

TCC<\/p>\n<\/blockquote>\n

Other populations:<\/h3>\n
\n

Commercial: Cigna, Aetna, United
\nMedicare Advantage: multiple payors<\/p>\n<\/blockquote>\n

Quality Metrics:<\/h3>\n
\n

Common HEDIS Measures_v2<\/a><\/p>\n<\/blockquote>\n","protected":false},"excerpt":{"rendered":"

Overview What is Value Based Care? Value-based care is a care delivery model that prioritizes patient outcomes\u00a0in the way that health providers are reimbursed. In this payment system, physicians and hospitals are rewarded for improvements to their patients health\u00a0within a reporting\u00a0period, including reductions to the effects and incidence of chronic disease and\u00a0adherence to preventative care….<\/p>\n

Read more<\/a><\/div>\n","protected":false},"author":10,"featured_media":0,"parent":480,"menu_order":2,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"acf":[],"_links":{"self":[{"href":"https:\/\/depts.washington.edu\/uwmedptn\/wp-json\/wp\/v2\/pages\/775"}],"collection":[{"href":"https:\/\/depts.washington.edu\/uwmedptn\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/depts.washington.edu\/uwmedptn\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/depts.washington.edu\/uwmedptn\/wp-json\/wp\/v2\/users\/10"}],"replies":[{"embeddable":true,"href":"https:\/\/depts.washington.edu\/uwmedptn\/wp-json\/wp\/v2\/comments?post=775"}],"version-history":[{"count":2,"href":"https:\/\/depts.washington.edu\/uwmedptn\/wp-json\/wp\/v2\/pages\/775\/revisions"}],"predecessor-version":[{"id":794,"href":"https:\/\/depts.washington.edu\/uwmedptn\/wp-json\/wp\/v2\/pages\/775\/revisions\/794"}],"up":[{"embeddable":true,"href":"https:\/\/depts.washington.edu\/uwmedptn\/wp-json\/wp\/v2\/pages\/480"}],"wp:attachment":[{"href":"https:\/\/depts.washington.edu\/uwmedptn\/wp-json\/wp\/v2\/media?parent=775"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}