The U.S. spends more on healthcare than any other nation — nearly $5 trillion in 2023 alone, equaling about $14,570 per person. Additionally, the U.S. spends approximately twice as much on healthcare as other high-income countries — in most cases, for worse results.
Despite this massive investment, many Americans still struggle to access affordable, high-quality care. The problem isn’t just cost; it’s the way care is delivered and paid for.
Traditional models often prioritize volume over value, which can lead to unnecessary treatments or overlooked health risks. Meanwhile, people from underserved communities face even greater barriers to care, widening gaps in health equity and outcomes.
The good news? Employers can play a critical role in addressing these issues. By adopting value-based care strategies, they can offer more than just health insurance — they can actively support the long-term health and well-being of their workforce.
Table of Contents
- Key Principles of Value-Based Care
- Team-Based, Data-Driven Care
- Why Value-Based Care Is Gaining Momentum
- Addressing Health Equity Through Value-Based Care
- Improved Health and Productivity
- Lower Healthcare Costs
- Increased Employee Satisfaction
- How Value-Based Care Models Can Help Contain Costs
- How Vālenz Health® Can Help Employers Shift to Value-Based Care
Understanding Value-Based Care
In our current healthcare system, care often begins after a person is already sick. A value-based care model takes a different approach. It prioritizes a proactive, preventive, and patient-centered approach to care that focuses on overall well-being and long-term outcomes.
In a traditional fee-for-service model, providers are reimbursed based on the volume of services delivered. On the other hand, a value-based approach ties payments to quality, with hospitals, doctors, labs, and care teams earning incentives for providing care that improves health outcomes and controls costs.
Key Principles of Value-Based Care
A value-based approach follows several core principles that influence how care is delivered and measured.
First, there’s a strong emphasis on preventive care and early intervention, which aims to identify and treat health issues before they become more serious. This supports better patient outcomes while reducing the need for high-cost treatments, specialists, and hospitalizations.
Another core principle is the shift from volume to value. In a value-based care model, providers are evaluated and reimbursed based on patient outcomes instead of the number of services performed. This encourages more meaningful and personalized interactions with patients.
Personalized care is central to a value-based care model. Care isn’t one-size-fits-all; instead, it’s tailored to each person, with their specific needs, preferences, and goals influencing decisions.
One of the most important aspects of this model is a holistic view of care and health. Social determinants of health — such as housing, education, income, and access to nutritious food — are considered essential factors that influence a patient’s ability to maintain good health. By incorporating these factors into care strategies, providers are better able to address root causes of poor health outcomes and ensure all people have equal access to care.
Team-Based, Data-Driven Care
The healthcare system is complex, and it can be confusing and overwhelming for patients to navigate on their own. With a value-based approach, healthcare becomes team-based and often led by the primary care physician. The team helps patients manage chronic conditions, schedule follow-ups, and stay engaged with their treatment plan.
By sharing information and communicating openly, providers, patients, and payers can work together to identify care gaps and encourage follow-through on preventive screenings, prescriptions, and annual exams.
Why Value-Based Care is Gaining Momentum
Healthcare is becoming increasingly expensive, and one of the top influencing factors is the traditional fee-for-service model. Because providers are paid based on the number of services performed, they may order additional tests and procedures that are unnecessary.
A value-based model makes sure services are worthwhile and drive outcomes, resulting in cost savings, reduced waste, and more value from healthcare choices. For example, providers may spend more time on services that aren’t typically covered in the traditional model, such as counseling. Because value-based care takes a data-driven approach, providers and patients are able to make more informed and cost-effective decisions.
Addressing Health Equity Through Value-Based Care
Value-based models recognize that health is shaped by more than medical care.
People from disadvantaged backgrounds often face barriers to care that can result in higher rates of illness and shorter life expectancy. With a value-based approach, providers are able to address many causes of health disparities that can lead to poor outcomes.
For example, providers are better able to identify at-risk populations with data analysis, connect patients to supportive programs and services, and develop partnerships that promote community well-being. This type of care delivery provides all patients with opportunities to lead healthier lives.
Benefits of Value-Based Care
Employers that embrace value-based care see wide-ranging benefits for both their workforce and their bottom line.
Improved Health and Productivity
Value-based care helps employees better manage chronic conditions, such as diabetes or heart disease, through coordinated treatment and ongoing support. This results in fewer emergency room visits, hospitalizations, and readmissions. When employees receive timely and appropriate care, they spend less time navigating health issues and more time staying productive and engaged at work.
Lower Healthcare Costs
By focusing on prevention and early intervention, value-based care helps avoid the high costs associated with late-stage disease and unnecessary treatments. It promotes the use of urgent care centers and walk-in clinics instead of emergency rooms when appropriate and encourages the prescribing of cost-effective generic medications. Providers are also incentivized to eliminate duplicative tests and rely on evidence-based care plans, reducing overall waste.
Increased Employee Satisfaction
With value-based care systems, employees experience consistent, more personalized care that aligns with their health goals. Clearer communication with care teams and greater access to navigation tools enhance their confidence in the system. When employees feel supported in managing their health, it improves their care outcomes, morale, trust, and satisfaction with their benefit package.
How Value-Based Care Models Can Help Contain Costs
Using a data-driven approach like value-based care means greater cost savings without sacrificing quality. By focusing on early detection and addressing risk factors before they escalate, providers can prevent complications and reduce reliance on emergency services. With effective management of chronic conditions, hospital admissions and readmissions can also be reduced.
A key factor of a value-based approach is care coordination. Ensuring all care team members are aligned minimizes delays in care and helps avoid duplicate or unnecessary treatments. Additionally, data-driven insights support more informed referrals and direct patients to the most appropriate and cost-effective care site. Emphasizing the use of generic medications whenever possible can also result in significant savings over time.
Together, these strategies can contribute to a more effective system that delivers better care while significantly reducing waste and lowering long-term healthcare costs.
How Vālenz Health® Can Help Employers Shift to Value-Based Care
Vālenz Health® helps employers put value-based care into action with strategies that are personalized, cost-conscious, and easy to navigate. Our tools are designed to support both employee health and employer goals with one-on-one guidance and transparent provider comparisons.
With NaVcare, members get dedicated support from care navigators who help them understand their benefits, eligibility, and claims. Navigators also offer personalized support to help members find affordable, in-network care options and connect them with low- or no-cost community services based on location, needs, and income.
Meanwhile, the Bluebook Provider Directory™ makes it easier for employees to make informed choices. Providers are scored using a green/yellow/red system that reflects cost, quality, and the appropriateness of care. Users can search by procedure or provider to quickly identify high-value options that fit their needs and budget.
The result? Reduced healthcare spend, higher levels of member engagement, and better care outcomes for all.
Ready to see how Valenz can support your workforce with value-based care options? Get in touch today to learn more and see how solutions such as Bluebook and NaVcare can support your employees.