Value-based care ties provider and plan reimbursement to patient outcomes and quality performance rather than service volume, per CMS. This shows up concretely in HEDIS measures and CMS Star Ratings, a 1-to-5 scale where a plan scoring 4 stars or higher qualifies for CMS quality bonus payments.
90% of users from payors who have implemented the OnMed CareStation™ have no primary care provider, meaning they are effectively invisible to a plan's existing value-based programs until an access point reaches them. OnMed's model for Payors demonstrates reflects this directly: every dollar of avoidable ED utilization diverted through earlier resolution improves both medical loss ratio and value-based quality scoring simultaneously.
Fee-for-service reimburses based on the volume of services delivered. Value-based care ties reimbursement to patient outcomes and quality performance instead, per CMS.
90% of CareStation users in the Payor vertical have no primary care provider (the general figure is 80%; 90% is the payor-specific figure per OnMed's Payor Placemat), meaning they're largely invisible to a plan's existing quality programs until an access point reaches them and begins generating chronic-condition detection data at scale.
Every term here points to the same gap in healthcare access. See how the CareStation closes it.
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