| Payment for illness or sick care that is triggered by visits to providers and procedures done |
Payment for prevention, care coordination, and care management at the primary care level |
| Greatest financial award for specialized services |
Payment for populations—shared risk for use of specialized services |
| Provider-centric, provider as expert |
Patient-centric, patient as partner |
| No accountability for inadequate quality. Quality and quality improvement tasked to a department |
Value-based payment asking “How well did patients do?” Quality and quality improvement prime concerns of every practitioner |
| Quality measured at the individual level |
Quality measured at the individual and aggregate levels |
| Quality measured for a discrete time period |
Quality measured over longer periods |
| Inconsistent access to care |
Same-day appointments, timely access |
| Disrespect |
Respect |
| Top-down hierarchical command and control. Leadership focused on siloed area of care |
Team-based, collaborative care requiring integration of care across the continuum |
| Nursing not leading or not recognized for their contribution to care |
Nursing finding their voice and take an active role in shaping the future of healthcare. Nursing recognized for their value in care coordination |
| Following orders |
Advocating for the patient and the family |
| Focus on task |
Focus on excellence and the patient experience |
