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Case Management & Value-Based Healthcare—Why It’s Essential Today

In today’s age, the term “value-based” healthcare is continually gaining traction—but the implementation is far from perfect. Through it, healthcare treatments aren’t solely focused on providing treatments for profit; healthcare practitioners are becoming more mindful of the results for an overall better quality of life for the patient.

Helping further its propagation is the ideology of care management, which is really starting to shine in today’s health climate. Far from being just the transition of patient information, this collaboration of information between healthcare practitioners has paved the way for even better value-based health programs.

To cement the importance of the two even further, here are some points as to why they are essential today:

They Work Together to Offer Proper Medical Care

Due to the growing medical care expenses for treating chronic diseases, a vast population in the US cannot benefit from the current status of the healthcare system. The costs continue to rise, and health insurance fees keep increasing—leaving people fending for their own lives.

With problems constantly expanding from left to right, specialists withhold decisions regarding treatments and procedures for fear of insufficient data that can put lives at risk. Diagnostic tests become unnecessary if they don’t provide the results that lead to a better quality of care.

Through the combination of case management with value-based solutions, the focus has shifted towards creating better outcomes rather than the number of procedures required to treat patients. This, in turn, paves the way for a more caring healthcare system that can be beneficial for everyone.

They Work Together to Help Prevent Unwanted Resolutions

There has been a shift in handling medical concerns, particularly with the introduction of a more holistic mindset. Patients that undergo lifestyle changes, basic medical exams, proper treatments, and behavioral health integration noticed the difference value-based healthcare brought to them rather than through other methods.

Combining case management and value-based care is the key to achieving better care solutions that involves a patient’s particular medical history. It can also allow healthcare providers to access data before deciding on costly additional diagnostic exams or expensive over-the-top treatments.

Besides that, value-based healthcare also includes prioritizing the safety of patients by eliminating irrelevant prescriptions. It can also aid in monitoring progress and comparing how effective a treatment is for each different patient.   

They Work Together to Analyze Essential Data

Health information technology (HIT) continues to lead value-based healthcare as the main medium of disseminating data—which is why medical communities have learned to rely on HIT to enhance how they offer care. It is also a way for experts working in hospitals to uphold data sharing using value-based care.

Through effective case management, better health treatment plans are developed, allowing a more seamless transition between healthcare practitioners when it comes to a particular patient’s treatment. Aside from that, their progress is detailed and collated, which simultaneously allows the creation of health statistics that can help improve the way particular treatments are carried out.

They Work Together to Manage Each Patient’s Healthcare Plan Better

A case management procedure is usually all-inclusive to give individuals proper healthcare. The approach is also open for collaborations by analyzing patient records and studying each of their qualities to help medical providers handle individual plans better.

In this case, more time can now be spent on treatment and reaching for better healthcare rather than getting stuck on excessive diagnostics. Through proper patient information transitions, a more streamlined process is then put into effect.

With case management, patients have the option of receiving tailor-made solutions that focus on value-based care. In turn, clients end up with better healthcare programs and quality of life.

Conclusion

Health coverage doesn’t always have to be hard to achieve. You just have to choose the right treatments and trust the professionals. Relying on case management solutions with value-based medical plans is one way to help you achieve proper care, prevent unwanted outcomes, receive the correct data, and manage your health plan accordingly.

Are you looking for a provider of transitional care management solutions in the US? Medistics Health is dedicated to caring for patients with returning conditions, behavioral health cases, and transitional needs. Get in touch with us today and allow us to simplify your health!

Profit Calculator Assumptions: 40% of total Medicare patients enrolling is based on (i) Medicare Chart Book’s data showing that ~68% of medicare patients qualify for CCM (2 or more chronic conditions), and (ii) that ~40% of eligible patients will enroll.

For typical providers, $46.67 of net profit per patient per month is based on a Medicare reimbursement per patient per month (national average) for various care management CPT codes.

CPT and other codes, descriptions and other data are copyright 2011 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA).