Study finds that the healthcare industry needs to do more to educate consumers on value-based care

Oct. 13, 2021

EmblemHealth, one of the nation's nonprofit health insurers, has released its findings in a national survey of what Value-Based Care means to patients and consumers. The national study found that only one in four consumers is aware of the term "Value-Based Care," and of those, only a quarter can define it accurately. These results are a call to action for healthcare professionals and policy leaders.

"Our findings show that it is crucial for healthcare leaders to improve communications around the purpose and benefits of Value-Based Care," said Karen Ignagni, EmblemHealth President and CEO. "Now is the time for health plans, clinicians, and policymakers to bring clarity, communication, and understanding of consumer familiarity with this language."

Value-Based Care is a model that aligns payers and providers [doctors] by reimbursing providers for the quality of care given to ensure better patient health outcomes. The model represents a shift from the fee-for-service model, which reimburses providers based on the volume of services provided rather than the outcome or value. A key concept is that if prevention, early intervention, and care management succeed, individuals will remain healthy longer and pay less for service as other complex procedures are required less frequently. This model is significant for improving population health and for controlling the costs of the entire health system.

In the years following the enactment of the Affordable Care Act in 2010, the value-based model has gained prominence through federal programs administered by the Centers for Medicare & Medicaid Services and has continued to gain traction among commercial payers. While the widespread transition from "volume to value" of services signals a shift in the paradigm of reimbursement arrangements, more understanding of how consumers perceive the model needs to be a focus.

As part of the survey, people indicated that quality of care resonates with them most when thinking about Value-Based Care, closely followed by affordability/cost. Moreover, the term "Value-Based Care," while commonly used within the healthcare sector and in policymaking, is not widely understood by consumers. However, when Value-Based Care is understood, consumers are very supportive of the mission and intend to improve health outcomes while reducing the cost of care.

Other key findings include:

  • Of those familiar with the term, 58% of respondents recall hearing "Value-Based Care" from a health insurance plan, followed by 40% from a doctor and 27% from a media/news outlet.
  • After doctors, respondents cited health plans as an essential contributor to adding value to health care: 40% said their doctor is responsible for adding value to their health care, 28% said their health insurance plan is responsible, while 26% placed the onus on themselves.
  • Overwhelmingly, respondents (63%) felt that both doctors and health insurers should communicate about Value-Based Care.

More results from EmblemHealth's study