Framing Value Based Healthcare in Practice: Introducing the Complex Case and Recovery Management Framework (The CCaRM).

Abstract

There is a gap between aspiring to co-produce and co-create value in integrated healthcare and realising that in practice, particularly with complex needs and multiple stakeholders. Key principles from literature on value-based healthcare offer a conceptual framework for building suitable care platforms to support practice. This paper outlines the Complex Care and Recovery Management Framework (CCaRM) as an example of co-platforming value-based healthcare within case level practice. The CCaRM was co-produced with clinicians and service users in a learning disability service. Highlighted are 6 value-making themes for building collaborative value over time, alongside case management. "Experience-in-use" was that it made sense to participants, and activated service-users and clinicians. Further empirical evaluation is needed. There was encouragement that the CCaRM approach was implementable. Alongside further evaluative work, key issues would be: collaborating with local participants; supporting training; reconciling case-level perspectives with wider systems. Progressing integrated value-based healthcare involves: refreshing focus on the case-based view; ways of operationalising complexity; value-based case management; customisation of care styles and "democratic outcomes" within co-platforming systems. In principle, the CCaRM contributes to operationalising collaborative value-based healthcare for complex cases. It surfaces further research themes to refocus value and integrated care thinking. Further empirical work is needed.