The Future of Healthcare is Value-Based Holistic Care — Peter W. McCauley, Sr.
The future of healthcare is one where we treat the whole person — addressing physical health, mental health, social circumstances, and the broader factors that shape well-being. This shift toward holistic care is essential as we move toward value-based care models. Whole body care, which integrates physical and behavioral health, has the potential to improve patient outcomes, reduce costs, and create a more sustainable healthcare system. This is vital as we strive toward health equity, ensuring all individuals have access to the care they need.
Last year, the Centers for Medicare & Medicaid Services (CMS) launched the Making Care Primary (MCP) model, a 10.5-year initiative to transform how primary care is delivered in the U.S. The MCP model is part of a broader push by CMS to create a more integrated healthcare system. It focuses on care coordination and provides primary care clinicians with resources to connect patients with specialists, community-based programs, and other key components of their health journeys. This approach focuses on improving quality of care while reducing costs by prioritizing prevention, chronic disease management, and better integration of behavioral health.
Implementing such value-based care models is not without its challenges. Many primary care practices, especially in underserved areas, lack the infrastructure necessary to adopt these models effectively. In the TechTarget article “Overcoming the Barriers to Value-Based Payment in Primary Care,” Victoria Bailey notes that many providers struggle with the upfront costs associated with technology adoption and hiring additional staff to support value-based care. To succeed, practices must have the resources to track patient outcomes, engage with specialists, and monitor quality metrics — efforts that require substantial investment in both time and money.
One significant barrier to the widespread implementation of value-based care is the administrative complexity. Providers often must navigate a maze of varying quality metrics from different payers, which makes it difficult to implement consistent strategies across a diverse patient population. Moreover, primary care receives less than 5% of total healthcare spending, according to the CMS. This shortfall in funding means that primary care physicians are expected to address a wide range of issues with limited financial support.
To address these challenges, it is critical to make upfront investments in technology, staffing, and infrastructure. Financial support can help practices implement telehealth capabilities, hire care coordinators, and integrate behavioral health services — all of which are essential for delivering holistic, value-based care. Without these investments, many practices will be unable to manage patient populations effectively or participate in value-based care models that prioritize long-term outcomes.
Our healthcare system must shift its focus from short-term cost savings to long-term benefits. By linking payment to improved patient outcomes, providers are incentivized to focus on prevention, chronic disease management, and the integration of behavioral health services. As Sarah Sams, MD, pointed out in the TechTarget article, when value-based care is implemented correctly, providers can spend more time addressing the needs of their patients rather than simply managing visits. This shift toward proactive care will ultimately reduce hospitalizations, emergency visits, and costly interventions, leading to long-term savings.
Integrating behavioral health with primary care, investing in infrastructure, and simplifying value-based care models are crucial to achieving health equity. These steps will help ensure that every patient receives the care they deserve. By prioritizing these efforts, we can build a healthcare system that improves outcomes and reduces costs. The vision of holistic, value-based care is not a distant goal — it is the future of healthcare. This is a future we must build together, with commitment and action.
Read more about the CMS MCP model here
Read the original article from TechTarget here
With extensive leadership experience in the provider and payer spaces, Peter W. McCauley leads a national team of Medical and Nurse Executives. They offer clinical support to healthplan matrix partners in U.S. commercial markets. This includes new business medical client sales and retention, supplemental health benefits, and customized medical solutions for large national employer clients. They also provide value-based care solutions that translate improved clinical outcomes and cost reductions into employer client total medical cost savings. Dr. McCauley continues to practice pediatrics on Chicago’s far south side.
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