As the healthcare industry has evolved, so too have the ways in which care is delivered and reimbursement is captured. Today, two main approaches dominate the healthcare landscape: volume-based care and value-based care. While the former is often focused on maximizing reimbursement through the number (or volume) of services rendered and patients seen, the latter takes a more holistic approach, emphasizing quality outcomes, care effectiveness, and patient satisfaction as a means of receiving reimbursement and reducing costs.

While arguments can be made for either model, federal programs like HITECH and Meaningful Use — which stress detailed documentation and billing techniques — have bred an environment that lends itself increasingly towards volume-based care. As a direct result, providers are facing a crippling administrative load, leading to high clinical burnout and decreased patient satisfaction. Despite efforts to alleviate the administrative burden through tools like dictation, transcription, and medical scribes, it's become clear that these approaches are merely stopgaps incapable of properly reducing the administrative load.

However, by utilizing advanced technologies like artificial intelligence, it is possible to mitigate the crippling effects of medical documentation and provide an effective escape valve for healthcare providers. With AI, the gap between volume-based care and value-based care isn't as vast as it once was. In this article, we will explore the pros and cons of both value-based care and volume-based care and how AI-powered solutions like DeepScribe can help provider organizations deliver high-quality care while simultaneously minimizing administrative overhead and still maximizing reimbursement.

Issues with Volume-Based Care

Despite its prevalence in modern healthcare, volume-based care comes with a number of drawbacks that can negatively impact patient outcomes and provider well-being.

Quantity over Quality

Literally. In volume-based care models, also known as "fee-for-service" models, healthcare providers and organizations receive compensation based on the quantity of services they provide or procedures they perform. This approach is known to lead to overdiagnosis and overscreening, which stresses resources thin and ultimately harms patients.

High Administrative Burden

The focus on quantity over quality in volume-based settings leads to an overwhelming amount of administrative work for healthcare providers. Clinicians are pressured to over-code and document every detail to ensure optimal reimbursement, which spirals quickly to impact every element of the clinical day. Increased administrative load for each patient means providers are often more focused on documenting during the visit, and thus unable to engage intentionally with their patients. This leads to decreased patient satisfaction, increased documentation demands, and less time between visits to review and prepare for the next patient.

Burnout and Lowered Patient Satisfaction

In volume-based care, providers are often forced to overextend themselves to see as many patients as possible in a day, while also ensuring that they check all the necessary administrative boxes for reimbursement purposes. This pressure can lead to burnout and lowered patient satisfaction. According to Medscape's 2022 Physician Burnout and Depression report, 47% of physicians feel burned out (up 5% from 2021), with 60% citing administrative tasks like documentation as the primary contributor. This is a concerning trend, as physician burnout has been linked to lower-quality patient care, decreased job satisfaction, increased rates of depression and thoughts of suicide among physicians, and increased medical errors.

Over-billing, Over-coding, and Unnecessary Procedures

In volume-based care systems, providers may perform unnecessary procedures or over-bill to maximize revenue. This practice can lead to higher healthcare costs for both patients and payers, lower trust in the healthcare system, and lead to negative impacts on patient care, provider satisfaction, and healthcare costs.

Value-Based Healthcare

Value-based healthcare is a relatively new concept in the world of medicine. Unlike volume-based care, which emphasizes the number of services provided, value-based care focuses on the quality of care delivered. The goal of value-based care is to improve patient outcomes by encouraging preventive measures and providing care that is both efficient and cost-effective. Certain markers for the success of value-based care include patient satisfaction and hospital readmissions among others.

Benefits of Value-Based Care

By prioritizing preventive care and addressing chronic conditions, value-based care aims to keep patients out of doctor's offices, and rewards organizations for doing so. Additionally, by taking a more holistic approach to care, providers can address not only a patient's medical needs, but also their social determinants of health, such as economic stability, education access, housing, food security, and social and community context. Valuing and understanding the patient as a holistic entity helps lead to better patient experiences and care satisfaction.

For providers, value-based care can help reduce burnout and improve job satisfaction. By prioritizing quality, providers can practice what likely brought them to medicine in the first place: authentic patient connection and genuine care for their well-being, which is known to lead to higher job satisfaction and reduced burnout.

Challenges of Implementing Value-Based Care

Despite the benefits of value-based care, there are significant challenges associated with its implementation. Just as the federal government incentivized healthcare organizations to adopt electronic health records with the HITECH act, similar incentives must be implemented in order for organizations to adopt value-based care practices. There's simply far too much infrastructure built around EHRs, documentation, and reimbursement to unwind volume-based care models overnight. A systemic overhaul is needed, with buy-in from organizational stakeholders and decision-makers. The reality is that the industry is years away from shifting towards value-based care entirely.

The good news is that they might not have to.

DeepScribe and how AI can make The Best of Both Worlds

Recent advancements in artificial intelligence demonstrate that technology can help healthcare organizations achieve both volume-based and value-based care by automating administrative tasks and allowing providers to focus more intently on care delivery.

DeepScribe, the world's most widely adopted ambient AI scribe, is one of the first to tackle this. Using AI, natural language processing, and machine learning, DeepScribe captures the natural conversation between clinician and patient and uses it to write comprehensive medical documentation. With DeepScribe ambiently listening in the background, clinicians can focus on their patients during the visit without ever having to pick up a pen or type into their computer, making DeepScribe the first AI technology to significantly reduce the burden of documentation and untether clinicians from electronic health record systems.

The result is a "best of both worlds" scenario for healthcare organizations where DeepScribe provides an affordable solution that allows clinicians to provide value-based care while allowing organizations to maximize revenue and reimbursement. By automating documentation, suggesting billing codes, and synching complete notes directly into the EHR, DeepScribe significantly reduces the administrative workload for clinicians, enabling them to focus more intently on their patients during the visit. This inherently helps foster a clinical environment that better lends itself towards value-based care measures, allowing clinicians to provide more engaged care, improve patient satisfaction, and reduce burnout.

Overall, DeepScribe's innovative use of AI technology shows great promise in improving healthcare delivery by bridging the gap between volume-based and value-based care. To learn more about how our AI scribe is shaking up healthcare documentation fo the better, request a consultation with our team of experts.

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