• Angel Alfaro | MD

There is Value Based HealthCare in America-True or False


Value as defined by Merriam-Webster's Dictionary is the monetary worth of something (market price), a fair return or equivalent in goods, services, or money for something exchanged, relative worth, utility or importance, or something intrinsically valuable or desirable.

Are you getting value from your healthcare system? Professor Michael Porter from the Institute for Strategy and Competitiveness at Harvard Business School says:

" Value = Patient Health Outcomes per dollar spent" and "Choice and Competition are powerful forces to encourage continuous improvement in value and restructuring of care."

Think of all the things you pay for and use on a regular basis. If your cell phone bill went up or they didn't provide the service you expected from them what would you do? Would you just say "oh, well, I have to have a cell phone and this is what they charge." Or, would you call them up and say..."Hey, wait a minute. I agreed to pay XXX for this service and you are not providing me with what we agreed upon!" Did you know that you can do that with your healthcare services too? Certainly there are limits within each and every health insurance plan, but what is health insurance? Do you agree it should be there to help out in extreme emergencies and to cover major events or should it cover every single aspect of your health? Where does our own accountability for our health end and the insurance company's begin? Should they be allowed to deny you for smoking or because you utilize too many services? Should doctors who try to say they have great outcomes be allowed to fire you because you didn't do what they said or advised?

The government, specifically the Centers for Medicare and Medicaid Services (CMS) are trying to improve healthcare delivery. They are working on transitioning to a value based system where doctors and facilities will get paid based upon the quality of care compared to the cost. Commercial insurances are working to do the same. While I am not opposed to value based care, I am opposed to someone telling me that I am and am not providing valuable services. Shouldn't you the consumer decide the value? The acute care model works very well in most cases, however, the model for caring for chronic diseases in this country is despicable in my opinion. I don't know what exactly the government and commercial insurances companies will finally come up with, but it is a work in progress.

Are you going to wait for the government to determine what is valuable to you or are you going to decide what your health is worth? What do you think is reasonable to pay for healthcare? Who should decide what your health priorities are?

I challenge you to think outside the box and think about a new model of care delivery. What would it look like? Would it be a monthly fee like a gym membership, or one lump sum for chronic disease management? Who should pay? What would your ideal doctor-physician patient relationship look and feel like?

Healthcare delivery is changing and like everything else I pay for, I expect to get what I pay for.

I look forward to your thoughts and comments.


10 views0 comments

Recent Posts

See All

154 Fairbanks Drive, Valdez, Alaska 99686

PO Box 2507, Valdez AK, 99686    |  livingwell@thealfadoc.com

Patient Portal

© 2020 | The Alfa Doc

907-835-2532

livingwell@thealfadoc.com