Time as a Currency in Value-Based Care
My Time is Valuable
It’s been just over five years since I wrapped up treatment for my second bout with breast cancer, and this week, my oncologist finally said the magic word: “cured.” After the first round of surgeries and chemo, 10 years ago, I thought cancer was behind me. But five years later, a second one appeared (thanks to BRCA1), and my perspective on time changed completely.
Time became this precious, elusive thing, slipping through my fingers like sand. During those eight months of intense treatment, with no guarantees, all I could think about was wanting more time with my daughter, who was just eight then, more time with my life partner, and more time to build something impactful in healthcare. Yep, building a healthcare company was actually number three on my “if I survive this” list.
Time became the ultimate currency—the only one that truly mattered. Reflecting on all the other people battling disease, dealing with aging, facing end-of-life, or caring for a sick loved one, I realized how crucial time is. That urgency and sense of purpose pushed me to start Dimer Health and dive deep into value-based care (VBC). My nearly 20 years in healthcare as a clinician, operations leader, and strategist revealed a clear gap in clinical coverage as patient’s experience a transition of care, a moment in the care continuum where time is of the essence.
VBC is Not a Zero-Sum Game
Dimer Health is eliminating the discharge care gap for all people and providing high value to patients, providers, health systems and payors. VBC is not a zero sum game and as healthcare innovators shaping the future of healthcare, we have to think deeply about what metrics define “value” and success when it comes to care delivery. All of the stakeholders can win - the patient, provider, hospital/health system, and payor. VBC sounds great: patient-centered care, outcome measurement and accountability, cost-efficiency, collaborative care, and financial incentives all leading to better outcomes for patients, cost-savings (for the healthcare system not necessarily patients), enhanced provider experience, and provider accountability. Here’s the thing - while the ideals are lofty, its uptake and implementation have been fragmented and slow due to a range of systemic, operational, political and cultural challenges.
For example, during the COVID pandemic, a healthcare executive told me that their specialists were less productive with telemedicine compared to in-office care. The solution? Rush doctors back to in-person care to restore efficiency (and revenue). But what about patients? They saved hours by avoiding travel, waiting in the waiting room, saved money on parking, child or eldercare, and lost hours at work…away from their lives. How did we miss this obvious measure of success—patient’s time? Outcomes were unchanged. Here’s a wild idea: create pathways that empower our health system to care for patients at the most appropriate location, at the needed cadence for the person (not the diagnosis), through a modality that garners the greatest success. It's time to change our metric of success in VBC and pay for TIME well-valued.
Putting the Patient (People) First
A care delivery model that truly puts patients first encompasses patient-centered care, outcome measurement, cost efficiency, and collaborative care - metrics matter. While financial incentives provide a mechanism to promote these practices, they aren’t strictly necessary for achieving VBC’s core goals.
Integrating time as a "currency" in value-based care can drive innovations in care delivery and support a more equitable, effective and sustainable healthcare system. This approach improves resource utilization, productivity, convenience, quality of life for patients and providers, work-life balance for the care team, focus on direct patient care, and optimized resource allocation. By valuing time, healthcare systems can enhance the patient experience, improve provider well-being, and achieve better health outcomes across populations. When time is the measure, the number of healthy days becomes the measure of success.
My oncologist is an incredible physician and human and I literally owe him my life (he saved it twice). During my follow up visit last week, I realized that we could have economized both of our time and easily accomplished the visit virtually, while still maintaining our strong connection - sans the hug. Nowadays rather than a doctors office, I want to spend my healthy time with Lily, Anthony, and building in healthcare.
