The Future of Healthcare

How employers can prepare for value-based care

BY KAREN MARIE JOSWICK, MHA

THE HEALTHCARE LANDSCAPE is transforming significantly, moving from the traditional fee-for-service model to a value-based care approach. This transition has profound implications for Delaware businesses, affecting healthcare costs and employee wellness programs. As the state strives to improve health outcomes and address longstanding health disparities, understanding and preparing for this shift is crucial for local businesses.

Understanding value-based care

Value-based care is a healthcare delivery model that ties payments for care delivery to the quality of care provided and rewards providers for both efficiency and effectiveness. In this model, providers are compensated based on patient health outcomes, incentivizing them to deliver high-quality, coordinated care and promote overall wellness. Unlike fee-for-service, which increases the volume of services, value-based care focuses on improving patient outcomes and quality of care while managing costs. (1)

The shift towards value-based care

The movement towards value-based care has been gaining momentum for years, but recent developments have accelerated this trend. In 2022, the Centers for Medicare & Medicaid Services (CMS) announced a goal to have all Medicare beneficiaries in a care relationship with accountability for quality and total cost of care by 2030. (2).Commercial payers are following suit, with many major insurers implementing value-based care programs. (3)

The COVID-19 pandemic highlighted the vulnerabilities of the fee-for-service model and exacerbated health disparities, further pushing the industry towards a value-based care and health equity focus. (4) Health equity is achieved when everyone has a fair and just opportunity to attain their highest level of health. (5)

Delaware has made progress in some healthcare cost and quality aspects, but there’s room for improvement.

The U.S. News & World Report ranked Delaware second in the nation in 2024 for hospital quality.

Delaware’s Medicare Shared Savings Program ACOs generated $11.3 million in total savings in 2021. (6)

America’s Health Rankings ranked Delaware 18th overall for health outcomes, but 39th for high blood pressure and 42nd for diabetes prevalence.

This middling performance underscores the need for continued improvement, with a focus on prevention and access to primary care. Businesses can help with these health opportunities and address social determinants of health. One example to highlight is Unite Delaware, a network of partners that use Unite Us’ software to securely identify and support services that address the needs of individuals within the community. These efforts have shown promising results, but continued investment in value-based care and health equity initiatives are necessary to improve Delaware’s health rankings and outcomes.

Preparing for the future

As we move forward, collaboration between businesses, healthcare providers, payers, and community organizations is crucial in realizing the full potential of value-based care and achieving health equity in Delaware. The business community can play a pivotal role in this transformation.

Educate leadership: Ensure that decision-makers understand the principles of value-based care, its potential impact on the business, and its role in promoting access to care and improved quality.

Promote wellness programs and use of technology: Develop robust employee wellness programs that align with the preventive focus of value-based care. Explore digital health solutions—like telehealth and remote patient monitoring—to help employees better manage their health and connect with providers, ensuring they are accessible.

Promote wellness programs and use of technology: Develop robust employee wellness programs that align with the preventive focus of value-based care. Explore digital health solutions—like telehealth and remote patient monitoring—to help employees better manage their health and connect with providers, ensuring they are accessible.

The transition to value-based care represents a significant opportunity for Delaware businesses to improve employee health while potentially reducing healthcare costs and addressing health inequities. With Delaware’s accountable care organizations already demonstrating millions in savings and high-quality scores, the potential for value-based care to positively impact business bottom lines and community health is clear.

By embracing this model, Delaware businesses can be at the forefront of healthcare innovation, driving better health outcomes and economic benefits for the entire state.

1 NEJM Catalyst. (2017). What Is Value-Based Healthcare?

2 Centers for Medicare & Medicaid Services. (2022). CMS Outlines Strategy to Advance Health Equity.

3 Health Care Payment Learning & Action Network. (2022). APM Measurement Effort.

4 Health Affairs. (2020). COVID-19 And The Rise Of Value-Based Care Models.

5 Robert Wood Johnson Foundation (2017) What Is Health Equity?

6 Delaware Health Care Commission. (2023). State Innovation Model.

Karen Marie Joswick, MHA, is the founder and president of Benevolence Health.