Outcome Based Healthcare

Outcome based healthcare is a healthcare system that focuses on reducing variations in how a variety of diseases and conditions are treated. This process requires all clinicians to provide accurate diagnoses and treatment algorithms to improve patient outcomes.

Outcome based healthcare is a popular topic in the healthcare industry but that doesn’t mean there is a general and standard definition of what the term means. There is no standard definition and that’s mainly because of its scope. Outcome Based Healthcare encompasses a vast spectrum of strategies used to transition from fee-for-service to value based care. Despite the lack of a standard definition, healthcare practitioners and industry leaders do agree on one thing: health systems need to embrace outcomes-based healthcare in order to survive the transition to value-based care. While lots of organizations are slowly making the transition to value-based care, many other organizations are overwhelmed by hoc challenging the transition and the new system is and will be to the way they run their organization and do business.

Outcome based healthcare is the ultimate goal of the industry. The primary beneficiaries of outcome based healthcare are without a doubt the patient population who are on the receiving end of health services. The main benefit to health systems pursuing outcomes-based healthcare is having a patient-centered vision that motivates everything they do.

Healthcare organizations and healthcare practitioners want to provide the best possible care to their communities. But the fee for service model has continued to interfere with that important goal. Rather than striving to save lives and provide the best care, health systems stuck in a fee for service world spend most of their time managing inefficiencies and solving problems. SO it unquestionable that a value-based approach is a welcome improvement. While the transition to outcomes-based healthcare is the ideal path toward restoring health systems’ ability to deliver on their promises to communities, they need an approachable, attainable guide for successfully making the switch. An outcomes-based framework requires calculated, thoughtful restructuring to meet current and future needs—and provides an ongoing template for driving continuous improvement.

In addition to the benefits mentioned above, outcomes-Based Healthcare is also reactive and proactive. Most outcomes-based healthcare definitions center on a reactive approach to healthcare and curing diseases, for example. Operating in reactive mode, health systems continuously ask how can we prevent diseases instead of just curing sick patients.

In outcomes-based healthcare, health systems focus on reducing variation in how they treat a wide variety of diseases and conditions. This is a process that requires all clinicians to provide accurate diagnoses and treatment algorithms to improve patient outcomes. Health systems are constantly striving to overcome inefficiencies and provide high quality care to patients. Although improving the way health systems care for sick patients is vital, it is not the only goal of outcomes-based healthcare as solely focusing on improving health system inefficiencies is myopic.

Outcomes-based healthcare also targets a more proactive approach to healthcare. This approach is centred around creating healthcare systems that strive to maintain healthy populations and prevent illness. Embracing the proactive aspect of outcomes-based healthcare leads health systems to consistently ask several questions like: How do we maintain the health of our patient populations? How do we prevent illness and keep individuals out of the hospital? How do we operate outside our system walls to optimize community healthcare? How do we incorporate population health into our business model?

Challenges in Switching to Outcome-based Healthcare

As mentioned already, transitioning from fee for service to outcome based healthcare is not an easy task and presents some challenges. Three of the main challenges are

  • Limited Analytics Capabilities
  • Limited Access to Information
  • Inappropriate Organizational Structure