Value-Based Care as Integrated Care

Those are promising signs. On the other hand, the fundamental economics of the value-based arrangement still aren’t clear. If fee-for-service turns out to more profitable for both payer and provider, then value-based care won’t survive outside of Medicare Advantage. And there have been failures in the past, as cited above.

Under value-based care, payers win financially when their members are engaged and receiving the right care, because that’s how they both drive membership AND limit costs. Patients are the winners.

Data Provocation: Hospitals are broken and ripe for technological disruption. I have been following General Catalyst’s bold moves lately, including helping found several healthcare companies and most recently acquiring an entire healthcare system in the United States. My hope is that this leads to a vertically integrated re-imagination of healthca

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In the value-based scenario, scale is not nearly as important as in fee for service. While it still helps in some ways (e.g. for investing in tech platforms), it’s no longer the primary basis of competition. So in shifting to a value-based arrangement, much of the incumbents’ advantage is reduced.