The need to move from a volume-based to value-based payment plan has emerged as a result of unnecessary expenditures citizens were sometimes forced to undertake. Volume-based care has at its core the reimbursement of procedures and services depending on their number and volume. That is, a patient pays for the service he or she has received. This approach seems logical and wise as long as one does not stop to think about the correlation between quantity and quality, which is not always logical (Lopez et al., 2020). Frequently, healthcare organizations or individual practitioners may perform the procedures not necessarily helpful or needed by the patient only to increase the amount of payment to be made. Meanwhile, volume-based care focuses on preventative care and the procedures that can be undertaken to improve health and reduce costs for individuals and the healthcare system.
The Pioneer Accountable Care Organization (ACO) Model was introduced with the aim of supporting providers and organizations involved in care coordination across various settings. The ACO Model enables the mentioned facilities to make a faster transition from a shared-savings payment method to a population-based one (Centers for Medicare & Medicaid Services [CMMS], 2021). The ACO will enhance quality due to the involvement of different organizations and providers and their ability to share experiences (CMMS, 2021). The model improves equity since it works for different population groups. Finally, the ACO will impact efficiency due to the strategies of saving costs and providing high-quality care within a short time. As a result, the model is expected to raise the quality of services and bring about better outcomes both for patients and providers.
The Oncology Care Model (OCM) and the ACO seem to share the effect on the triple aim of equality, equity, and efficiency. Both approaches aim to reduce costs and improve healthcare delivery while simultaneously eliminating the burden on health workers. I think that the model you selected for discussion has the most impact on the efficiency aim. As you have stated, the primary goal of the OCM is to reward and stimulate those providers who willingly accept the shift in the healthcare delivery paradigm. Hence, this change is largely focused on increasing efficiency. I believe the model has all the perspectives to stand the test of time since both patients and providers are interested in the suggested options. As a healthcare professional, I would be interested in supporting this option since I believe that all people, especially underserved populations, should have equal health opportunities.
Both the ACO and the Global and Professional Direct Contracting (GPDC) models focus on bringing more value to patients. The ACO, as well as the GPDC, strives to make people pay less, eliminates the waste of resources, and improves access to care by all. However, I think that the GPDC is more useful than the ACO in terms of efficiency as it enables providers to have more flexibility. Furthermore, it is highly useful in terms of equality since it is more individualized than the ACO. I believe the GPDC is highly likely to stand the test of time since its goals are relevant and attainable. As a healthcare provider, I would be interested in applying this model in practice since it would enable me to focus on value-based care, which is the goal every provider should pursue.
References
Centers for Medicare & Medicaid Services. (2021). Pioneer ACO Model.
Lopez, M. H., Daniel G. W., Fiore, N. C., Higgins, A., & McClennan, M. B. (2020). Paying for value from costly medical technologies: A framework for applying value-based payment reforms.