Woman on a teleconsult appt with a doctor
06/16/2021

Should Health Care be Value-Based? | Costs, Outcomes & Value

When we make a purchase, we look for a quality product or service at a fair price — in other words, we look for value. Shouldn’t we expect the same for our health care dollars?

Sleep health care particularly lends itself to the concept of value. Patients who are tested for obstructive sleep apnea and receive a positive diagnosis frequently do not follow through on treatment. Not only has money been wasted, but the patient didn’t receive needed treatment. Patients with sleep apnea often have systemic health issues like diabetes and cardiovascular disease, which can’t be properly managed when sleep issues are not addressed. The patient and benefit plan sponsor have received no value for the dollars spent.

When treating a sleep issue, taking into account the full picture of the person’s health is key to a successful outcome. Are there chronic conditions that need to be considered alongside the sleep issue? Are there multiple sleep issues or is depression an underlying problem causing sleep disruption? What behavioral changes need to occur to be treated successfully? Looking at sleep in isolation doesn’t provide the patient with full value for the sleep care service.

Costs and outcomes are also important factors in the value equation and should be looked at in tandem. Healthcare, including sleep care, is usually paid on a fee-for-service model, which rewards the provider for the volume of services but not for better results. A bundled payment arrangement syncs better with the longer-term needs of sleep care patients.

Finally, in evaluating sleep apnea treatment, has the patient acclimated to the therapeutic device? Is he or she still using the device nightly a year later? These are required and measurable outcomes that ultimately delineate value.

Read more about the opportunity for value-based sleep health care here.

Photo by Drazen / AdobeStock

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