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T.R.U.S.T: The Real Understanding of Social Trust

The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.

By Tekisha King
January 17, 2020

Trust is defined as the firm belief in the reliability, truth, ability or strength of someone or something. A valued-based care model approach aspires a level of trust in the delivery of healthcare services to strengthen the patient, provider, payor, and public relationship. Similarly, the social cognitive theory (SCT) encompass the three main elements —the person, environment, and behavior to probe social determinants and personal factors amplifying poor health outcomes.  A trustworthy patient and provider relationship entails education and resources to foster better informed healthcare decisions, minimize costs and to improve health outcomes. Furthermore, valued-based care models aim to enrich patient-centered care and health outcomes while also reducing health costs in the United States healthcare delivery system. 

The Baby Boomer generation (1946-1964) is changing the traditional lifespan, escalating a new modern lifestyle model with preventative medicine and healthy behaviors. Laura Pritchard-Jones explored, “Ageism and the impact on a person’s ability,” in the 2017 Healthcare Analysis article, “Ageism and Autonomy in Health Care:  Explorations Through a Rotational Lens.” The vulnerable populations (senior citizens, disabled and mentally impaired populations) require high-cost healthcare services to rapidly expand, cultivate differentiated health professionals and transform health care. “The link to self-relations concepts are self-trust, self-worth and self-esteem” said Laura Pritchard-Jones. Likewise, self-relation concepts are imperative with augmented educational tools to abide by the revolution of value-based care models. 

The value-based payment model structures best practices with health care programs and provides incentives to providers based on quality performance metrics. The Centers for Medicare and Medicaid (CMS) initiated seven original value-based programs:

  1. End-Stage Renal Disease Quality Incentive Program (ERSD QIP)
  2. Hospital Value-Based Purchasing (VBP) Program
  3. Hospital Readmission Reduction Program (HRRP)
  4. Value Modifier (VM) Program
  5. Hospital Acquired Conditions (HAC) Reduction Program
  6. Skilled Nursing Facility Valued Based Program (SNFVBP)
  7. Home Health Value Based Program (HHVBP) (CMS, 2020)

Although the programs target the Medicare program, all programs can be applied to government, commercial and private health plan beneficiaries with medical diseases acquiring advanced medical treatment. In addition, the VBPs reflect proclaimed federal legislations: The Affordable Care Act (ACA), the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA), the Medicare Improvements for Patients & Providers Act (MIPPA) and the Protecting Access to Medicare Act (PAMA) (CMS, 2020).  Moreover, inclusive collaboration can reduce and prevent health infections and adverse drug events with set performance benchmarks to improve quality initiatives. 

Social determinants are factors impacting personal traits and the health status of populations due largely to healthcare access. Social determinants affect human behavior, including an individual’s cognitive and physiological state, intensifying the need for behavior and mental health treatment. “Population health management emerged as a vital tool to shift and adapt health organizations to shift away from fee-for-service to value delivery of health services,” according to Rosemary M. Caron, Anne M. Hewitt, Julie H. Carmalt, & Edmond A. Hooker in the 2018 Journal of Health Administration Education article, “Teaching Population Health:  Innovations in the Integration of the Healthcare and Public Health Systems.” Analyzing health data enables health organizations to collaborate with factual statistical data and set performance and quality metrics while exploring adverse health outcomes. Caron, et al., in 2018, validated that, “The integration of public health and primary care can capitalize effective collaboration among healthcare in specified regions and communities with population health management.” To conclude, public and private health entities can assimilate global healthcare solutions by amalgamating systems with population health management. 

Behavior is defined as the way in which one acts or conducts oneself, especially towards others.  Mental health behaviors impact a person’s mood, thinking and behavior controlled with medication assisted therapy (MAT).  Jochen P. Ziegelmann and Nina Knoll studied,“Health behaviors and fostering old aged health behaviors,” in the 2015 Gerontology article,“Future Directions in the Study of Health Behavior among Older Adults.” They looked at health behaviors, “In older adults to discover a distinction between proximal (e.g. physical activity) and distal (e.g. social participation) health behaviors.” The rise of mental and behavior health sectors has commenced access to patients coping with unplanned life stressors blighting the health status. “Positive health behaviors avoid harm, enhancing physical fitness and disease prevention to prolong life expectancy” according to Ziegelmann and Knoll. Although human behavior changes with unwarranted life stressors, advanced medical treatment alternatives with MAT, education and resources can permit informed medical decisions. 

Accountability standards are to be upheld in an equitable manner with ethical practices from the patient, provider and payers for a successful healthcare delivery system.  Value-based care programs are designed to improve healthcare access with practical quality standards of care, effective use of technology and holding everyone accountable for their due diligence.  For instance, if the patient seeks preventative medical treatment, the provider should educate the patient with cost-efficient treatment options conducive to improving the health status. Secondly, the patient should consult with the health plan to learn to understand how to maximize health benefits. Lastly, the health payer corroborates to simplify health services, expand provider networks and personalize health programs. Thus, united, we can transform the United States healthcare system with, “TRUST,” to improve access to primary care, costs and health outcomes to prolong lifespans for Americans.    


Author: Tekisha King, Ph.D. Candidate. Tekisha attest and sponsor to the transformation of a Value-Based Care (VBC) health care model expansion to revolutionize an equitable patient-centered delivery health system.  She is firmly focused on the delivery of interdisciplinary collaboration, integrated technologies, and robust business partnerships to benefit diplomatically.  Tekisha manages differentiated health policy projects focused on assimilated quality improvement initiatives solutions. Email: [email protected]. Twitter: @Tekisha30Lotus 

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