Is volume the key to value-based care success?

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The healthcare industry has tried to parse the seemingly paradoxical relationship between volume and value for years. Can the two models exist side by side? Should providers eventually transition entirely to one model over the other?

Healthcare media coverage often describes the hospital "journey from volume to value," suggesting volume-based healthcare is considered the model of the past, one that will eventually be abandoned for a future rooted in value-based care.   

However, a recent panel discussion reframed this idea. Speaking on a panel called "The CEO Paradox: Can You Really Have Volume and Value?" at the Becker's Hospital Review 8th Annual CEO + CFO Roundtable in November in Chicago, hospital leaders discussed the idea that volume-based care, appropriately applied, can support value-based care efforts.

The panelists were Caitlin Beck Stella, CEO of Memorial Healthcare System's Joe DiMaggio Children's Hospital in Hollywood, Fla., and Kate Henderson, regional hospital president of Ascension Seton in Austin, Texas. Rick Stevens, president of Christian Hospital in St. Louis, moderated the discussion.

It may seem that volume-based care, which incentivizes providers to see more patients and order more tests and procedures, is inherently at odds with the goals of controlled cost and quality under value-based models. However, the panelists suggested that volume doesn't need to be eliminated from hospital and health systems' strategic vocabulary. Instead, it needs to be shifted into a different part of the spectrum of care. They suggested hospitals and health systems focus on building volume upstream to move patients into more appropriate settings of care, lower costs and provide a better patient experience, leading to better quality of care.

Key areas where health systems can focus volume-related efforts are telehealth visits, urgent care and outpatient care sites, and primary care practices. Investing in those upstream care settings can help start to build the wraparound system of care and wellness necessary for value-based care success.

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