VBC 101
This model rewards providers for successful outcomes, not volume of services.
What is Value-Based Care?
The chance that a patient may experience a negative health outcome.
What is Risk?
These are specific, evidence-based actions aimed at improving outcomes for high-risk groups.
What are Targeted Interventions?
These are the conditions where people live, work, and grow that influence health.
What are Social Determinants of Health (SDoH)?
This refers to how often and in what ways a patient has used healthcare services in the past.
What is Historical Utilization?
This traditional payment model reimburses providers for each individual service.
What is Fee-For Service?
The process of identifying high-risk patients to prevent poor outcomes.
What is Risk Stratification?
These tools include care pathways, medication optimization, and remote monitoring.
What are Clinical Levers?
These differences in health outcomes are measurable but may not always be caused by unfair systems.
What are Health Disparities?
When utilization is higher than medically necessary, it is considered this type of spend.
What is Impactable Spend?
The measure of how effective, safe, and person-centered health services are.
What is Quality of Care?
The framework Imagine Pediatrics uses to determine timing, team, and tech for outreach.
What is V3?
Actions like health coaching and housing support fall under this type of lever.
What are Non-Clinical Levers?
This term describes avoidable and unjust differences in health linked to systemic disadvantage.
What is Health Inequity?
The type of spend that is necessary and appropriate. Effective utilization of external medical services.
What is Non-Impactable Spend?
This term refers to how serious or complex a patient's health condition is.
What is Acuity?
This identifies which patients are most likely to benefit from timely interventions.
What is Clinical Impactability?
This term defines how much positive effect Imagine Pediatrics can have on patient safety and cost.
What is Impactability?
Managing health outcomes across a group with a focus on reducing disparities is called what?
What is Population Health?
In VBC, this is used to flag inefficiency or gaps in care based on past service usage.
What is Historical Utilization?
These two types of spend define whether a cost is necessary or avoidable.
What is Impactable and Non- Impactable Spend?
This type of severity guides how care is allocated based on condition complexity and progression.
What is Clinical Severity?
This defines the diseases or conditions targeted for care—like asthma, diabetes, or mental health.
What are Therapeutic Areas?
This strategy is used to ensure the right intervention is given to the right group at the right time.
What are Targeted Interventions?
A patient who frequently visits the ER for unmanaged asthma and lives in unstable housing is an example of what?
What is a High-Risk, High-Impactable Patient?