Value-Based Care

Value-Based Care (VBC) is a healthcare model that emphasizes quality of care, practitioner performance, and patient experience — instead of focusing on the volume of services. VBC rewards physicians based on the quality of care they provide, patient health outcomes, and overall patient experience rather than the number of services they provide and bill for.

Goals of Value-Based Care

  • Improve patient experience
  • Promote health equity
  • Enhance health outcomes
  • Ensure cost-effective care
  • Support practitioners

Benefits of Value-Based Care

Improved Patient Outcomes

Incentivizes practitioners through preventative care and quality-driven approaches, leading to measurably better health results for patients.

Lower Healthcare Costs

Focuses on preventive care to avoid unnecessary and avoidable costs — such as emergency room visits — reducing the overall financial burden on patients and the healthcare system.

Improved Care Coordination

Uses integrated communication to coordinate a single patient’s care across multiple healthcare practices and practitioner’s, improving engagement and reducing redundancy.

Connected Provider Networks

Enables different practitioners from different organizations to communicate, share lab results, and coordinate — avoiding duplicate services being performed and billed over the same time period.

Programs & Sub-Categories

AHEAD

All-Payer Health Equity Approaches & Development Model

Maryland’s AHEAD Model is a voluntary, beneficiary-focused advanced primary care program that aligns Medicare with state-led primary care efforts. Primary care practices participate in transformation activities designed to align with AHEAD goals.

Goals: Increase capacity for care coordination, connection to resources, quality improvement, person-centered care, and lessen practitioner burden.

Who can participate? Primary care practices (including FQHCs and RHCs) located in participating states or sub-state regions that are in the state’s Medicaid Primary Care Alternative Payment Model (APM) or Patient-Centered Medical Home (PCMH) program.

EQIP

Episode Quality Improvement Program

A voluntary Advanced Alternative Payment Model (AAPM) for practitioners who treat Maryland Medicare beneficiaries through care transformation and value-based payment via an episode-based approach.

  • Holds participants accountable through cost and quality targets for specific clinical episodes.
  • Provides incentive payments to physicians who improve quality of care and reduce the cost of care.

📚 Learn more about EQIP: CRISP Health — EQIP Curriculum

CMS

Centers for Medicare & Medicaid Services

CMS modernizes Maryland’s all-payer rate-setting system, allowing the state to obtain new policies that reduce hospital costs and improve health outcomes across the board.

MDPCP

Maryland Primary Care Program

Provides funding and support for advanced primary care — including care transformation, prevention, chronic disease management, and prevention of unnecessary hospitalizations. The program is voluntary for all qualifying Maryland primary care practitioners.

Learn More — Resources

American Medical Association

ama-assn.org

CMS — Value-Based Care

cms.gov

HSCRC / MD.gov — AHEAD Model

hscrc.maryland.gov

MedChi — Center for Value-Based Care

medchi.org

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