Transforming Healthcare with Value-Based Care and Health Equity

from Hugh Lytle

Employers continue to struggle with healthcare costs and how much benefit they can provide for the dollar. It comes down to the quality of the care that’s provided to their employees and the ability to easily access high-quality, high-value care.

We are seeing a few major trends converging in the healthcare industry today. First is the shift to value-based care (VBC), which is a framework and a major movement in the U.S. health system for improving care quality and access while lowering costs to improve outcomes and population health. VBC is a healthcare delivery model under which providers — physicians, clinicians, lab resources, etc. — are paid based on health outcomes of their patients and the quality of service rendered. The traditional model entrenched in our U.S. health system is fee-for-service, which is a volume game in which providers are paid based on how many services they can deliver. 

VBC has been around for more than a decade and, while the goal of delivering higher care quality at a lower cost may sound counter-intuitive, this form of improved care delivery is making significant headway and has accelerated coming out of COVID. Our company, Equality Health, is one of the nation’s leading drivers of value-based contracting through our set of ambulatory care services and provider technology platform, CareEmpower, delivered to support independent primary care practices. We are seeing tremendous progress working with our health plan and provider practices to make real impact in underserved communities across Arizona and Texas. We view primary care practices as the engine of change, as many times they are the first touch point for patients on their care journey. 

Caring for a Dispersed and Culturally Diverse Workforce

Of course, companies today are also dealing with the challenges of a diverse, remote workforce, which puts myriad pressures on employers. As associates are spread out, working from their home office, employers must support them with in-home tools needed to do their job. They must be in compliance with the local employment laws and provide high-value, low-cost healthcare coverage across multiple states. While larger companies always had to address multi-state healthcare coverage, now a company as small as 150 team members can have associates in 30-plus states. 

Other trends directly related to healthcare include improved access to “culturally competent care,” which is tightly connected to another key trend: health equity — ensuring a fair and equitable healthcare care delivery system for all. 

Employers need to ensure that they are giving their employees access to low-cost, high-quality providers. With today’s diverse workforces, employees increasingly want a culturally competent provider — one who speaks their language and is well versed in their values. So, an employer’s benefit design should recognize the importance of optimizing an individual’s health, with an understanding that care is in the eye of the beholder. 

VBC models offer a host of whole-health benefits for their associates, ranging from promoting better health, engaging employees to play a more active role in their own health and reducing ineffective treatments to lowering costs, improving access to care and providing more support for chronic conditions. It’s an outcomes-driven approach with an aim of population health for any type of community, whether that’s a localized neighborhood in Tucson or a geographically dispersed employee base for a company. 

Employers should survey their employees to better understand the gaps that exist and satisfaction levels with existing benefits. Numerous studies cite employee demand for better access to preventive care, improved medication support, access to behavioral health providers and more services being provided either in-home or virtually. All of these are features that are part of value-based care design. Employers should, additionally, align on providing benefits that are culturally congruent with their employee diversity mix and associated healthcare needs.

Enhance Wellness Services

Ultimately, benefits are important to attracting and retaining talent, and a happy, healthy workforce is a productive one. Companies want to be able to offer their employees the richest benefits for the lowest cost. This extends beyond primary care and embraces health and wellness support, gym memberships, provider networks for complementary alternative medicine, chiropractic services and more. So, company leaders should look for greater flexibility in health plans, including buy-up options for enhanced wellness services. 

Gone are the days when employees were satisfied with simple in-office perks. Healthcare is an important lure for associates. So, for employers, it’s more important than ever to take an active role in helping employees optimize their health –– including support for those employees and family members with chronic conditions. 

Rather than handing everything off to a third party, savvy organizations are seeking out personalized care delivery methods that are designed with the employee and their family at the center. Of course, much of this is variable depending on the size of the company, the number of employees involved and the organization’s geographic footprint. But taking that active role in employee wellness is becoming table stakes for many companies.

With new care delivery innovations centered around primary care, there are new opportunities for employers to offer benefits packages that help create a higher level of engagement with their employees and their families and, ultimately, drive improved outcomes and employee satisfaction. 

Hugh Lytle focuses on health service innovations that have a strong social mission and bring systemic change to the U.S. healthcare system. He is the chairman and chief executive officer and founded  Equality Health as a population risk management company focused on improving care delivery for the underserved.

See the full story: Ever-Changing Healthcare – The new impact healthcare is having on our companies and their people

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