FACT SHEET: New AAOS Value-Based Care Continuum Designed to Help Navigate the Fluid Health Care Landscape

The American Academy of Orthopaedic Surgeons (AAOS) recently developed a value-based care continuum (VBCC) to help orthopaedic practices better understand and navigate various alternative payment models (APM) created to achieve value-based care. The AAOS VBCC makes the existing—often opaque—value-based care landscape more digestible and understandable. This includes identifying where a practice’s existing payment arrangements fall along the VBCC, understanding the transition sought by purchasers/payers to value-based care, and planning for continued changes in APM payer contracting arrangements.

WHY NOW?
There is no question that the existing value-based care landscape can be confusing and daunting, with many incentives and structures. Various stakeholders have different definitions for the same terms that are used in a clinical setting, which only adds to the complexity. The VBCC serves to create a universal lens for interpreting this landscape. With the recent COVID pandemic, newer models that incorporate prospective (payment in advance of a service) may better insulate practices for the future. The AAOS VBCC outlines some of these arrangements.

DEFINING COST, QUALITY AND VALUE IS KEY
Demand for lower costs and more significant improvements to quality continues to evolve and mature, making it critical to define cost, quality and value and their relation to one another. In an effort to guide orthopaedic surgeons through this process, AAOS outlined a clear definition of cost, quality and value as follows:

Quality:

• is the successful delivery of appropriate, evidence-based musculoskeletal health care in an effort to achieve sustained patient-centered improvements in health outcomes and quality of life;
• is exemplified by a physician-led musculoskeletal team focused on the individual patient’s preference in the delivery of care that is safe, accessible, equitable, and timely;
• fosters evidence-based innovations essential for the advancement of professional and scientific knowledge.

Value:

• is defined as the relationship of a patient-centered health outcome to the total cost required to reach that outcome, given that:
  • care is evidence-based, appropriate, timely, sustainable, and occurs throughout a full cycle of musculoskeletal care for a patient’s condition; and
  • cost is of musculoskeletal care is an investment and includes consideration of greater lifestyle and economic impacts.

TO LEARN MORE
Orthopaedic practice administrators can access and download a copy of the VBCC online at:  https://www.aaos.org/quality/practice-management/value-based-care-guide. 

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