How VBC delivers on the quadruple aim

When we talk about optimizing health system performance in the value-based care (VBC) model, it’s common to refer to the quadruple aim: improved patient outcomes, improved patient experiences, improved provider experiences, and reduced costs. And the best way to determine whether or not the VBC model is delivering on these aims is to talk to those who work on the frontlines. So, we asked some VBC thought leaders to share their experiences of how the value-based care model delivers on the promise of the quadruple aim.


Improved provider experiences

A decade ago, a paper published in the Annals of Family Medicine by Thomas Bodenheimer, MD and Christine Sinsky, MD, recommended that the long-established triple aim be expanded to include “the goal of improving the work life of health care providers, including clinicians and staff.” At a time when clinician burnout levels sit at around 63%, this latest aim feels more important than ever.


Dr. Gabriel Waterman of SCAN Health Plan explains how he sees the difference between working in a traditional fee-for-service model versus a value-based one, in terms of the provider experience:


The reason I don’t work in fee-for-service is because I didn’t want to be measured by how many RVUs (relative value units) I had produced, or how many patients I’d seen that day. I knew that wouldn’t feel meaningful – and many clinicians who work in that sort of environment don’t even have access to outcomes data.


In value-based care, it’s all about the outcomes – and that’s just so much more rewarding for me as a clinician.

Dr. Waterman, SCAN Health Plan


Better patient experiences

When the success of a health system is no longer measured by patient volumes, it creates space and frees up resources to dedicate to improved patient care. Dr. Rayny Ramirez of Community Medical Group tells us of just such an experience:


I remember visiting another clinic, and I saw this senior walking in. No shoes, poorly dressed… just in a bad way. One of the medical assistants showed up, and returned 10 minutes later with shoes, clothes, food…. She just went and bought it with the funds available based on how the company operated. They even arranged for the person to sleep at a hotel for the next couple of nights.


These are things you cannot even imagine in fee-for-service.

Dr. Rayny Ramirez, Community Medical Group


Lower costs

Value-based care organizations won’t necessarily prioritize lower costs if they come at the expense of true ‘value’, expressed by the equation: 


As Dr. Ramirez explains: “It’s all relative to how you measure the value of VBC. In my previous stewardship, we were able to improve or extend life by an average of five years in seniors with a certain number of conditions. Potentially the costs are higher, but what’s the cost of living five more years?


But in many cases, cost and quality DO go hand-in-hand. Dr. Waterman picks up the baton, explaining how Medicare hospital-at-home programs can help to reduce costs and improve both the provider and patient experiences:


Even if it costs $1,000 to send a clinician to the home, do remote telemetry, and give them IV antibiotics, it’s still a lot cheaper than providing that care in the hospital… Again, as a clinician, it’s so rewarding if you’re able to say: ‘you really need IV antibiotics, but we can do this at home instead of in the hospital’. 


That improves the patient experience and offers satisfaction as a provider.

Dr. Waterman, SCAN Health Plan


Better patient outcomes

Finally, the last goal of the quadruple aim is arguably the most important – and to many, where the success of value-based care will be judged. It’s also where some of the most incredible, impactful stories can be found. Inspira Health’s Krystyna Sienkiewicz shares an experience from her early days with the Inspira team:


We had probably three people on the team, and we were doing things like transitional care management – so calling patients after they were discharged from an inpatient stay to get them to follow up with their PCP. We also covered some preventive metrics during those calls, and identified several patients that had not had their colorectal cancer screening. It was flagged for our nurses, they went over it, and they convinced the patients to do a fecal occult blood test – something they could do in the privacy of their own homes.


There were three patients who were identified with colorectal cancer, and they had no idea that they even had it. They were able to get the treatment that they needed and are now cancer-free.


That was a direct result of what we were doing from a value-based care perspective.

– Krystyna Sienkiewicz, Inspira Health


In conclusion:

Value-based care organizations like those represented by our three experts strive every day to deliver on the four tenets of the quadruple aim. But the documentation complexity inherent in the CMS risk-adjustment model can create additional challenges for providers. Fortunately, DoctusTech’s HCC training app provides an easier way for clinicians to learn the intricacies of HCC coding – offering up to 90% engagement and 75% knowledge retention. And at the point of care, our integrated platform works seamlessly with 70+ major EMRs to help clinicians raise chronic HCC recapture rates up to 92%.


If you’d like to make it improve documentation accuracy and make it easier for your clinicians to deliver exceptional patient care in the VBC model, book a demo with DoctusTech today.