Becker's Healthcare May 20, 2024
Preventive care delivery is one of the inalienable levers of value-based care (VBC). With the increasing VBC adoption, many healthcare payers have been offering care management programs that aim to promote overall member wellness by managing members’ medical conditions and preventing progression of chronic diseases.
At the outset, both members and payers have aligned incentives vis-à-vis care management programs, as these programs lead to improved member health outcomes and thereby reduced medical expenses. However, a closer examination of these programs reveals that payers’ financial incentives may not always align with the health outcome incentives of low-risk members. Failing to address this misalignment can negatively impact members’ health and increase costs.
Current Payer-Led Care Management Approach
Payers’ care management programs...
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