A Shift from Volume to Value: The Core Difference
Traditional primary care often operates on a fee-for-service model, where providers are reimbursed based on the number of services they provide, such as appointments, tests, and procedures. This system can sometimes incentivize quantity over quality and leaves little room for the deep, long-term patient relationships that are crucial for managing complex health issues.
Oak Street Health, in contrast, operates under a value-based care model, primarily for Medicare-eligible patients. In this model, the focus shifts to patient outcomes. Rather than being paid per visit or test, the healthcare provider is financially rewarded for keeping their patients healthy and out of the hospital. This fundamental difference reorients the entire care structure around patient well-being rather than billable services.
The Multidisciplinary Care Team Approach
One of the most significant ways Oak Street Health distinguishes itself is through its team-based care model. Instead of relying solely on a single primary care physician, each patient is supported by a dedicated team that may include a primary care provider (PCP), a clinical informaticist (scribe), a behavioral health specialist, a social worker, and community health workers.
- Comprehensive Support: The team works collaboratively to address a patient's physical, behavioral, and social needs. For example, a social worker can help with housing or food insecurity, while a behavioral health specialist can provide mental health support.
- Enhanced Communication: With a scribe managing documentation, the PCP can focus entirely on the patient during appointments, fostering a stronger and more trusting patient-provider relationship.
- Proactive Management: Community health workers conduct outreach to ensure patients adhere to their care plans, schedule follow-up appointments, and address any barriers to care they might be experiencing.
Longer, More Frequent Appointments
To facilitate the deep, personal connections necessary for effective preventative care, Oak Street Health offers significantly longer and more frequent appointments, especially for patients with complex needs. While a traditional primary care appointment may last 15-20 minutes, Oak Street Health's initial appointments can be 40 minutes or longer, with follow-ups scheduled monthly for the sickest patients. This allows providers to address multiple health concerns in depth, rather than rushing through a checklist.
Advanced Technology and Data Utilization
Oak Street Health leverages its proprietary technology platform, Canopy, to support its value-based approach. This system is designed to complement their Electronic Medical Records (EMR) software by identifying care gaps and predicting acute health risks.
- Risk Stratification: The platform helps categorize patients into different risk levels, allowing the care team to allocate resources effectively and provide more intensive support to those most in need.
- Proactive Intervention: By flagging potential issues before they escalate, the technology enables the care team to intervene early, preventing costly and disruptive hospitalizations and emergency department visits.
A Focus on Preventive and Social Care
Beyond the clinic walls, Oak Street Health places a strong emphasis on preventive care and addressing social determinants of health. These are non-medical factors, like socioeconomic status, education, and physical environment, that influence health outcomes.
- Community Centers: Many locations feature community centers that offer social and educational activities, fitness classes, and other programs designed to combat social isolation and promote a healthy lifestyle.
- Integrated Services: Some centers include pharmacies, making it easier for patients to manage their prescriptions. The integration of these services into the clinic makes healthcare more convenient and accessible.
The Financial Incentive Structure
The value-based model aligns the financial interests of Oak Street Health with the health of its patients. By assuming full financial risk for their patient population through capitation agreements, Oak Street is incentivized to invest in preventative care that keeps patients healthy. If patients require fewer hospital stays and specialist visits, Oak Street benefits financially, allowing them to reinvest in better care. This is a stark contrast to the fee-for-service model, where financial gain is tied to the volume of services delivered, not necessarily the patient's long-term health.
Comparison: Oak Street Health vs. Traditional Primary Care
| Feature | Oak Street Health | Traditional Primary Care |
|---|---|---|
| Care Model | Value-Based Care (Outcome-focused) | Fee-for-Service (Volume-focused) |
| Patient Population | Primarily Medicare-eligible older adults | Broad range of ages and insurance plans |
| Appointment Length | Longer (40+ mins initial), more frequent | Shorter (15-20 mins), less frequent |
| Care Team | Multidisciplinary team (PCP, social worker, etc.) | Primarily led by a single PCP |
| Technology | Proprietary platform (Canopy) for risk prediction | Standard EMR, less integrated risk analysis |
| Focus | Proactive, preventative, and social health | Reactive treatment of symptoms |
| Community Integration | Dedicated community centers and outreach | Limited community engagement and resources |
| Financial Incentive | Rewards keeping patients healthy | Rewards number of services provided |
Conclusion: Rebuilding Healthcare for Seniors
Ultimately, the core answer to how does Oak Street Health differ from others lies in its complete reimagining of the primary care experience for older adults. By shifting from a fee-for-service to a value-based model, it creates an ecosystem where patient well-being is the central goal. The combination of a proactive, team-based approach, longer appointment times, innovative technology, and integrated social services provides a more comprehensive and preventative form of care than is typically found in traditional primary care settings. This model demonstrably improves health outcomes for a high-risk population while also aiming to reduce overall healthcare costs. Learn more about value-based care on the Oak Street Health blog.
