Value-Based Palliative Care

The case for transforming how palliative care is funded and delivered is clear. Traditional fee-for-service reimbursement rewards volume, not value.  The payment structure doesn’t support the comprehensive, interdisciplinary support that people with serious illness require.  As a result, palliative care outside of the hospital or hospice in the U.S. has struggled to scale.  The payment doesn’t iincentivize practices to innovate or focus on outpatient care outside of hospice organizations.  

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Vynca is pioneering a different approach.

We think of reimbursement in a different way. We align to value and put our fees at risk — aligning payment with measurable outcomes in patient satisfaction, quality, outcomes, and avoidable utilization. We are about providing our patients more quality days at home™ while reducing total spend for payors.

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Current payment models do not work

For high-need, high-cost populations, the reimbursement on a fee-for-service schedule creates fundamental barriers:

• It does not cover the interdisciplinary clinical, social, and behavioral expertise required for whole-person care.
• It promotes reactive, visit-based care, not early identification, proactive engagement, and longitudinal support.
• It provides no mechanism to measure — let alone reward — patient experience, quality of life, or cost containment.

The result: fragmented care, late interventions, avoidable hospital use, and missed opportunities to support members earlier in their journey.

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What Makes a Model “Value-Based”

In palliative care, “value” must be defined and measured — not assumed. Vynca’s value-based approach ties performance to three domains:

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1. Patient Experience

• Member and family satisfaction
• Feeling supported, informed, and able to navigate their illness
  

2. Quality Outcomes

• Symptom reduction
• Documented goals of care
• Timely, appropriate hospice transition
• Increased median days in hospice
• Reduced burden on caregivers
  

3. Cost & Utilization

• Fewer avoidable ED visits
• Reduction in unplanned hospital admissions
• Lower total cost of care for high-need populations
  

These are outcomes that matter to members and to health plans — and they are the foundation of a scalable, sustainable value-based palliative care model.

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The Strategic Opportunity for Health Plans

For government and employer-sponsored plans taking on greater risk for complex populations, value-based palliative care represents a powerful lever to:

• Improve member outcomes and quality of life
• Reduce avoidable utilization and total cost of care
• Meet regulatory requirements tied to quality, population health, and risk management
• Enhance member experience, satisfaction, and retention
  

But success requires partners purpose-built for these models. Vynca’s integrated, technology-enabled approach is designed to deliver meaningful value under risk-bearing arrangements — not months from now, but starting on day one.

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We bring the clinical model, analytics, and operational rigor needed to make value-based palliative care real — and to deliver compassionate, whole-person support for the members who need it most.

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To learn more about how Vynca can support your practice, or to refer a patient today, visit vyncacare.com, email us at hello@vyncacare.com, or call 1-888-227-8884.