Financing Whole-Person Health

Area of Science:

• Healthcare economics
• Public health
• Health systems research

Background:

• Current U.S. healthcare payment models are unsustainable, leading to provider financial strain and poor patient health outcomes.
• Rising costs and inadequate results necessitate systemic solutions beyond minor adjustments.

Purpose of the Study:

• To explore systemic solutions for healthcare reform, focusing on whole-person care and viable payment systems.
• To align healthcare delivery with patient values and address physical, behavioral, emotional, and social determinants of health.

Main Methods:

• Examining the integration of whole-person care with effective payment systems.
• Analyzing the role of capitated payments, risk adjustments, social determinants of health, and expense trends.
• Evaluating the predominant fee-for-service model's limitations for whole-person care strategies.

Main Results:

• Capitated payments and risk adjustments are key components of an interdependent approach to healthcare reform.
• Addressing social and structural determinants of health is crucial for optimizing outcomes.
• Expense trends indicate a need for efficiency-driven payment models.

Conclusions:

• The Whole Health paradigm offers a pathway to optimize financial performance for providers and improve patient health outcomes.
• Phased implementation of this model is both feasible and sustainable.
• Systemic reform requires a shift towards value-based care and holistic patient management.