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A Value-Based System in Healthcare


In the context of present-day developments, medicine plays a crucial role, as it directly influences the standards of living and the average life span among the population. For this reason, the development of this field presents a matter of extreme importance, and the latest innovations introduced by researchers are applied in practice. For instance, several decades ago, health care professionals predominantly used to stick to a fee-for-service system and work in silos, though these days, a value-based system is gradually becoming an occurrence. There is a strong tendency to unite the knowledge and skills of medical specialists in different fields, and this is considered to be more progressive and effective in the long run. Thus, the purpose of this paper is to analyze the impact of the current policy on the medical staff, compare fee-for-service and value-based systems, and present personal reflections on the division of duties between workers.

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The Impact of the Current Policy

As it has been mentioned above, the field of healthcare is incurring some changes, namely uniting the efforts of workers in order to achieve the best outcomes. These days, it is considered that all the patients in all the settings in the United States should receive competent care, which responds to their unique needs and specialties (Burridge et al., 2017). Therefore, all the transformations in the healthcare practice are intended to achieve this aim. This concerns changes in the roles of health care workers, including nurses. They are required to occupy the central role in such transformations in order to improve access, efficiency, and other indicators of delivering medical services. This demand was claimed in 2010 with the introduction of The Affordable Care Act (Burridge et al., 2017). Consequently, health care professionals are required to participate in creating a patient-centered care system.

Mostly, the transformation of the practice affects nurses, as the range of their duties was expanded. In order to address the lack of healthcare workers, who are capable of delivering primary care (Burridge et al., 2017). In present-day developments, nurse practitioners, physicians, and their assistants are required to fulfill this kind of service as well. Therefore, it presents a satisfactory solution for the pressing concern described earlier. In general, the role of nurses in creating a complex health care system cannot be underestimated (Burridge et al., 2017). Apart from contributing to primary care, they are also engaged in ambulatory activities. They positively influence the quality of medical services and their accessibility. Thus, the current policy is intended to unite the efforts of healthcare workers, respond to individual needs, deliver patient-centered care, and make medical services more accessible.

The Distinction between Free-For-Service and Value-Based Systems

Despite the fact that there is a huge variety of payment systems in the medical field, the paper focuses only on two of them, namely free-for-service and value-based ones. The first one implies paying for each medical service delivered by health care professionals. It does not involve the outcome of the treatment but includes such indicators as volume and quantity. In order to realize it, medical providers are given permission to write paychecks (The Fox Group, 2019). At first glimpse, the system may seem rational, though “for far too long patients have been over treated, over-tested and prescribed more medications than could possibly be healthy” (The Fox Group, 2019, para. 4). Consequently, as medical institutes have been paid for each test, treatment, and other service, they have insisted on delivering additional, occasionally unnecessary, and duplicated services to patients.

In addition, in these conditions, healthcare providers are determined to supply their services as much as it is possible in order to obtain considerable profit. They are focused on the time spent on every client, and they tend not to conduct an in-depth analyses of the health state. Physicians intend to appoint as many patients as they can, which aggravates the quality of their work to a large extent.

Nowadays, it is possible to notice the shift to a value-based alternative, which gains popularity. It implies the opposite of the previous approach, and the patients are offered to pay for the efficiency and outcomes. Therefore, this methodology is intended to encourage specialists to improve the quality of medical services (The Fox Group, 2019). Unlike the aforementioned system, it also motivates the specialists to unite in groups in order to share knowledge and skills in various fields of medicine and provide a client with a comprehensive treatment (The Fox Group, 2019). The Fox Group (2019) marks: “this type of care model promotes a cradle-to-grave approach for each illness, making medical providers accountable for the entire care cycle of each patient” (para. 6). This way, a patient is highly likely to receive a more competent treatment, and healthcare providers are motivated to develop their knowledge.

A Personal Opinion on Sharing Power between Physicians and Nurses

The positive effect of sharing the duties between physicians and nurses cannot be denied, as a more significant number of patients are capable of accessing primary care. In addition, it is beneficial for improving the quality of medical service. In these conditions, it is possible to stick to patient-centered care and fulfill all the needs of a particular client. This way, it appears to be an efficient solution to the shortage of primary care.

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On the other hand, burnout and exhaustion have become common sight among nurses. According to the research of Wang et al. (2015), “both personal and environmental factors were correlated with nurse burnout; however, personal factors played bigger roles in predicting personal accomplishment” (para. 1). However, they also highlight: that “environmental factors played bigger roles in predicting emotional exhaustion and depersonalization” (Wang et al., 2015, para. 1). In general, nurses have to cope with multiple working tasks, as well as stresses associated with treating patients. Furthermore, the poor mental state of nurses gradually leads to their shortage (Wang et al., 2015). Therefore, there is a likelihood that adding new responsibilities, such as delivering primary care, may aggravate the situation and minimize the positive effect of the implementation. This may affect the quality of service as well. For this reason, it is essential to organize the sharing of power between specialists in complex with measures intended to cope with nurse burnouts in order to achieve efficiency.


In the context of present-day developments, Medicine presents a field, which is constantly developing in order to improve the outcomes of treatment. Consequently, a wide range of innovative ideas is implemented in practice. For instance, several years ago, healthcare providers used to stick to a fee-for-service payment system, which allowed them to derive enrichment by advising patients to attend unnecessary procedures. These days, a value-baes system is applied in order to improve the quality of treatment results. Therefore, patients are offered to receive more competent care, which includes an individual approach to their needs. In addition, sharing duties of primary care between nurses and physicians is among other recent implementations. Despite its positive influence on the accessibility and quality of medical services, it may have negative consequences in the long turn too. It is highly likely to aggravate the problem of burnout among nurses. For this reason, this implementation should be accompanied by appropriate measures intended to relieve the pressure put on nurses.


Burridge, L. H., Winch, S., Kay, M., & Henderson, A. (2017). Building compassion literacy: Enabling care in primary health care nursing. Collegian, 24(1), 85-91. Web.

The Fox Group. (2019). How does fee for service compare to value based reimbursement. Web.

Wang, S. Liu, Y., & Wang, L. (2015). Nurse burnout: Personal and environmental factors as predictors. International Journal of Nursing Practice, 21(1), 78-86. Web.

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