Value driven healthcare is the lasting legacy of the Affordable Care Act which had three
goals: to improve access to healthcare by increasing healthcare insurance coverage to improve
the patient's experience and quality of care and to slow the rate of increase in healthcare
costs. Regardless of changes to the financing of healthcare or changes in policy value-based
purchasing for healthcare is to remain a constant feature of the healthcare horizon.
Value-based purchasing is a demand side strategy to reward quality in health care delivery.
Value-based purchasing involves cost considerations and includes the actions of employers the
public sector health plans and individual consumers in making healthcare decisions. Effective
health care services and high performing health care providers are incentivized to provide
quality outcomes and to control cost. Value-based purchasing drives quality metrics which are
publicly reported and serve asimportant levers for changes in healthcare delivery. Geriatric
patients consume a disproportionate share of healthcare resources so CMS directs Medicare and
drives geriatric healthcare models. All other insurers generally model CMS Medicare guidelines.
Innovative geriatric care models which demonstrate improved outcomes and cost moderation are
scaled and lessons learned used to create new healthcare models. The best data for broader
value driven healthcare comes from the geriatric models which currently have the best data
available. This book traces the origins of value-based purchasing and current geriatric care
models and synthesizes their implications for today's changing health system. It also discusses
healthcare accountability and risk sharing. The audience includes geriatric healthcare
professionals but also a wider audience interested in broader healthcare models and value
driven healthcare from a policy economic and ethical perspective. These include primary care
physicians specialists who work with aging patients hospital administrators healthcare
educators healthcare organizations and all medical professionals working with aging patients
and patients affected by healthcare reform.
