Why the Success of Value-Based Care Matters

The United States spends more on health care than all other developed countries, and costs are expected to continually rise. At the same time, greater spending hasn’t resulted in better health outcomes for patients, with the U.S. trailing other industrialized countries in health rankings.

Recognizing that this pattern isn’t sustainable or effective, payers have spent the last several years designing and implementing approaches to payment that make the shift from paying for volume to paying for value. We believe that the shift to value-based care drives improvements in both the quality of care and patient outcomes—the ultimate goal of both health care payers and providers.

We’ve seen the need for this transition directly and personally. About a year ago, one of us (Robin), spent an extra inpatient night while waiting for the hospital to receive approval for outpatient treatment. Everyone was trying to do the right thing—the insurer to make sure they were paying for medically necessary care, and the hospital and doctors to make sure the right treatment was delivered and could be continued without a gap after leaving the hospital. In the end, it worked out well, but not without some significant stress and uncertainty along the way, along with added costs and increased exposure to hospital-based infections. Under a value-based payment approach, payers and providers have a greater incentive to work together toward the patient’s goals of good outcomes and good health—hopefully resulting in fewer situations like these going forward.

Beyond personal experiences, we bring our professional expertise to support this transition—and that of our colleagues at RTI International. We believe in the promise of value-based care, and that RTI’s Center for Health Care Advancement will help providers and payers capitalize on the opportunities that value-based care offers. This new venture takes RTI International’s more than 30 years of experience working for the nation’s largest payer—the Centers for Medicare & Medicaid Services—and applies it directly to solving the challenges health care payers and providers face as they transition from fee-for-service to value-based care models.

RTI is an applied research institute—an organization with a mission of improving the human condition, where our staff members are always on the lookout for work that has an impact and that matters on the personal level. The RTI Center for Health Care Advancement provides access to more than 600 experts and decades of expertise to help lower health care costs, improve quality, and improve patient outcomes. We look forward to working with you.