Value-Based Care is 3.0

New Primary Care Models
New Primary Care Models, Delivery Methods Save Money, Enhance Care

Valuebasedcare is 3.0 and DirectPrimaryCare is 2.0 an expert in primary care models told me Tuesday over fish tacos.

Here’s why he’s wrong:

  • VBC relies on the kindness of BUCAH.
  • Yet they are directly competing for PCPs.
  • So can set the amount they pay below realistic economics to drive VBC ACOs to their knees.
  • Like they did with dozens of services like independent imaging or orthopids or DME.
  • They will do the same to independentACOs married to VBC in primarycare then “rescue” them. Buy em cheap. They can later pay themselves a fair rate. A fat profit, in fact, because it’s not their money. It’s ours.

DPC is more resilient to this game largely opting off the tilted game board.

Why would they do this if VBCs offer great value? Because they can.

Call me a jerk, but VBC appears a race to the bottom until BUCAH owns it all. It’s so clear.


“We can get typecast as anti-insurance or anti-government,” Umbehr said but likes the idea of insurance used appropriately.

“Insurance is perfect for expensive things, hospitalizations, major car wrecks, your house catches on fire, but … you don’t submit an insurance claim to wash your car, to paint a new room in your house, [or get] an oil change. … Insurance is a great tool, but not for affordable things,”