Value-based Healthcare: 2018 Facts

Mindful innovation in healthcare

Posted Jul 04, 2018

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Many larger healthcare systems are now actively working on building a culture of value innovation. Value-based means that the return on investment (e.g., fees, compensation, and satisfaction) is based on an outcome—value and not volume—of healthcare services delivered.

The impact on quality of patient care is enormous. Providers value safety first, then value follows with the highest quality elevating access and excellent medical treatments.

Value-based Healthcare

Value-based healthcare is a healthcare delivery model in which all providers, including physicians and hospitals, are reimbursed for services based on value—patient health outcomes. This value-based outcome reflects monetary and quality of life worth. Worth entails relevance, meaningfulness, and practical usefulness (Porter, 2009; Gray, 2017). The tie-in of valuation and payments in healthcare is a timely, crucial consideration. The cost and consequences of delivering the outcomes measure the value.

Benefits of value-based healthcare delivery include:

  1. Patients spend less money to achieve better health, particularly in managing their chronic diseases. This significant cost savings is one factor leading to a more practical positive patient experience.
  2. Providers achieve more efficient patient care with fewer steps that are less labor intensive while engendering more patient satisfaction.
  3. Payers control costs and reduce risks. This efficiency means less depletion on payer’s premium pools and their investment.
  4. Suppliers of healthcare goods align more economically their pricing with patient outcomes.
  5. Society’s healthcare improves while costs for this improvement decrease, particularly in managing chronic diseases, costly hospitalizations, and medical emergencies.

How Does Value-based Healthcare Influence Innovative Healthcare Delivery?

Collaborative team-oriented approaches can expand in several ways that are operationally defined, measurable, and contribute to high-quality patient care. The primary care physician directs the patient toward a carefully designated care-coordinated team. Care-coordination and outcomes thus can display themselves transparently; they may be measured more easily. This initiative continues to be an area needing more in-depth improvement. This coherent efficiency translates to sharing of the electronic medical record (EMR) among all providers on the coordinated care team. This scalable innovation makes access to the patient’s information readily accessible and more transparent. Such data sharing reduces redundant care and associated costs.

The electronic health/medical record (EHR) or EMR is one of the most challenging technologies in modern medicine. By innovating its use in more user-friendly ways, the intention is to optimize its scalability to handle vast amounts of disparate data, coordinate them, and facilitate easy and fluid access to physicians. Not only can this enhance patient care and safety, but its optimization streamlines the physicians’ clinical workflow. The EMR and clinical workflow are endeavors in progress because they continue as unresolved challenges for physicians in everyday medical practice.

The vision of value-based healthcare delivery is to enhance the lives of people served by providing access to high value, patient-centered care in care-coordinated teams. Innovation and excellence pivot on several considerations: patient care, research, teaching, and service. All healthcare providers in and out of hospitals take part in this delivery.

Efforts to develop an organizational framework with a culture of value-based care at its core consist of several considerations:

  1. Developing new, creative, and transformative innovations that include products, processes, and services to impact in positive ways healthcare delivery.
  2. Inviting physician and care-coordinated team members to take part in contributing ideas to this innovative collaborative initiative.
  3. Making value-based healthcare more efficient, higher quality, and safer.
  4. Coordinating all inputs from all contributors.
  5. Maximizing collaboration with all stakeholders.
  6. Continuously monitoring total costs across the continuum of care.
  7. Inviting extensive collaboration with all who share this value-based healthcare delivery vision.

Ensuring positive progress in these endeavors is essential. Organizations need to be mindful of using improvement science to test the full range of approaches used. Improvement science applies innovation, rapid-cycle field testing, and dissemination to generate learning about changes that produce or fail to deliver improvements (Marshall, Pronovost, and Dixon-Woods, 2013). Using this method of tracking and measurement helps organizations determine whether the changes they test are leading to improvements, are effective in varying environments, are sustainable, can be extended, and require refinements.   

The above systems-based mindfulness endeavors need to be framed on a foundation of human-centered leadership to create a physician engagement-facilitating culture. A large part of this enthusiasm-inspired culture supports doctors to access positive emotions such as happiness and joy. This stability rests quietly on a platform of emotional equipoise that can become enduring. This emotional well-being maintains and reinforces resilience. It supports the care team’s ability to keep itself whole rather than grow disabled in the face of setbacks, stress, and inevitable adversities. This authentic integrity is the human face of medicine.

Important to remember: it is neither the isolated responsibility of the physician alone nor the healthcare system to work hard toward this equipoised transformation. The mutual participation of each is mandatory. Patient education and collaboration are essential.

References

Gray, M. (2017). Value-based healthcare (Editorial). British Medical Journal, 356: j437. doi : https://doi.org/10.1136/bmj.j437 (Published 27 January 2017)

Marshall, M., Pronovost, P., & Dixon-Woods, M. (2013). Promotion of improvement as a science. Lancet, 381(9864):419-421.

Porter, M.E. (2009). A Strategy for Health Care Reform — Toward a Value-Based System. New England Journal of Medicine, 361:109-112.