Value Based Programs

Value-based care (VBC) ties payments to high-quality care and cost savings to improve health outcomes, enhance patient experience and reduce care variation. VBC has emerged as an alternative to the traditional fee-for-service model, which instead focuses on payment for services billed regardless of quality and cost.

The key elements that drive success in a high-performing, value-based clinically integrated network include:

  • Care organized around patients’ medical conditions and directed to appropriate providers, treatments and settings
  • Reimbursement and incentives aligned to outcomes and efficiency of care
  • An information technology system that supports actionable reporting, such as closing care gaps and identifying coding opportunities

Rush Health participates in several value-based care programs. Some examples include:

  • Blue Cross Blue Shield of Illinois (BCBSIL) Accountable Care Organization
  • Aetna, BCBSIL and Humana Medicare Advantage Plans
  • Medicare Shared Savings Program