How can Digital Therapeutics Support Value-Based Care Models?
In recent years, there has been a healthcare reimbursement shift from a fee-for-services to Value-Based Care models (VBC). VBC challenges traditional models where providers are reimbursed based on the number of diagnoses performed or services provided.
VBC is based on the quality of care, rather than the quantity, and at its core, it helps to achieve the Triple Aim of healthcare systems:
- Provide better care to individuals.
- Improve population health management strategies.
- Reduce healthcare costs.
This transition from fee-for-service medicine makes even more sense in today’s healthcare ecosystem as providers feel burnout (particularly from providing non-stop care during the COVID-19 pandemic), costs continue to rise, and quantity and quality of care are regularly mismatched. After several years of implementation within the U.S. through specific programs, Value-Based Care has generated positive economic outcomes. As of 2020, accountable care organizations have saved Medicare nearly $1.7 million in gross savings and more than $835 million in net savings. The Center for Medicare & Medicaid Services (CMS) expects all traditional Medicare beneficiaries to be treated by a provider in Value-Based Care model by 2030.
Value-Based Care is data-driven, requiring healthcare professionals (HCPs) to closely monitor their patients and demonstrate that the care they provide improves patients’ health conditions. To get reimbursed, providers must report to payors’ specific quality improvement metrics, such as reductions of emergency room (ER) visits and hospitalization rates, as well as improved utilization of preventive care.
Healthcare digitalization efforts are moving in the same direction; Digital tools such as Electronic Health Records (EHRs), Electronic Patient Reported Outcomes, Digital Therapeutics (DTx), and a range of connected devices (from blood pressure monitors to smart watches to personal electrocardiograms) help care teams track and measure the impact of what they provide.
DTx play a particularly valuable role, as they are increasingly recognized by healthcare professionals as a relevant solution in the management of chronic diseases.