For nearly two decades, value-based care has been a hot topic in health care. And for good reason. After all, experts agree that the premise of generating a new care environment that prioritizes health care over sick care — today and into the future — is where health care needs to go.
However, as Javier Rodriguez, CEO of DaVita, explained during a panel at the 2023 HLTH conference, the term has become a catch-all phrase. “Value-based care,” coined in 2006, loosely refers to incentivizing care providers based on the value (improved access and health outcomes) served to patients while also reducing costs.
In the panel, “Value-Based Care in a Multi-Payer World,” Rodriguez argued, “The loose definition [of value-based care], I think, is bad for society because we don’t know exactly what that means.”
DaVita has been engaged in value-based care arrangements for more than 10 years. Now managing more than $5 billion in medical costs under management, one in three DaVita patients is part of a value-based care environment.
So, how does DaVita define value-based care and operate in it? It’s about taking accountability for patients’ health and well-being.
For the vast majority of its value-based programs, DaVita assumes full-risk, in which it manages the total cost of care for these patient populations, not just their kidney care.
Kidney care is a high-touch specialty: For patients who experience kidney failure and require dialysis, they may see their care team up to three times per week. People who do home dialysis treatments also have regular check-ins with DaVita caregivers, often including care tracking via the DaVita Care Connect® app available for patients. This visibility gives integrated care teams insight into an individual’s comprehensive health needs, the opportunity to help patients coordinate care even outside of their kidney health needs and help detect and intervene when someone is at risk of a negative health event.
As Rodriguez explained during the panel, DaVita’s work in value-based care required rethinking and reworking the foundation for the care model. When first starting, DaVita recognized that programs needed to be person-centric — identifying and developing the services based on the individual needs of each patient. They also knew physicians needed to be the leader in care.
“We’re going to celebrate physician independence,” Rodriguez recalled of early decisions on building out value-based programs. “We’re going to build everything around the doc [sic] so that they can serve the patient.”
Through the conversation, Rodriguez and the other panelists — Alisha Alaimo of Biogen, Dr. Jaewon Ryu of Geisinger Health System, Kate Ruder of Maven Clinic, and moderator Nancy Brown of Oak HC/FT — also weighed in on collaborative partnership across providers to succeed in value-based care.
Ultimately, innovation-focused entities must align on the same purpose: improved outcomes for patients. And success requires time.
Alaimo pointed out that the Center for Medicare and Medicaid Innovation (CMMI, an organization under the Centers for Medicare and Medicaid Services) has launched more than 50 value-based care models; with only a handful experiencing statistically significant cost savings. But, she and Rodriguez don’t think this represents failure — only signals the need to challenging convention and continuing to explore cohesive, integrated solutions.
“We better not stop on the innovation front,” Rodriguez shared, pointing to a long-term commitment to find the right solutions. “These things don’t happen year over year, but they happen over decades. And so we better continue.”