Value Based Model In Healthcare

Decent Essays
As we move to a value based model in healthcare, it is imperative we contemplate the dilemma of who is the ultimate risk bearer. At the end of the day, that entity should be the one receiving the financial value of our efforts. Presently, the entity holding the financial obligation for paying for services is not the recipient of the saved dollars. This is becoming more prevalent as newer and more expensive treatments are available that impact an illness early in the disease process. One might disagree with the premise that a certain level of healthcare is a right, but we as a nation have effectively made this decision. For instance, deemed as illegal to refuse treatment of emergent care, we do not allow people to die at the footsteps of our…show more content…
Is it a purely financial one? Obviously not, as the ultimate cost effective alternative is completely unacceptable to us. Since a human life has greater value outside of pure dollars and cents, we do not and should not take the cheapest route. Therefore, the issue becomes how we measure that value as it relates to services needed. Do we think about it on an individual level or a societal level? These are the conundrums we face. For instance, I go to the emergency room for a headache. I have no neurologic signs, nor is it the most debilitating pain I can imagine. In all likelihood, just to ensure that I do not have a deadly illness, I will receive a CAT scan of my head. As an individual, this is an excellent offering, but awful from a societal perspective, as the likelihood of finding an issue is low, and resources have been used that might have gone to the care of others. Our present payment model does not tie those two facts together. At a macro level, if we make the assumption there is only a finite pool of dollars, you can tie this CAT scan to a number of immunizations that could be given. Do I order the CAT scan or do I provide the immunizations? Is the quality about the individual or about the whole? Of course it depends on who is paying and what are the risks of not providing a
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