Abstract

There are still knowledge gaps regarding the landscaping of value-based health care (VBHC). The aim was to review the Swiss VBHC market and assess knowledge and concerns around VBHC in the healthcare system. First, a secondary desk research (SDR) was performed to review the VBHC market, to map key stakeholders guiding VBHC in Switzerland and to develop key intelligence questions for the interviews. The SDR was performed on Google, Yahoo, Google Scholar and PUBMED. Second, eight in-depth interviews were conducted among persons in decision-making positions representing the academic, digital health, payer, industry and consultant sector. They were interviewed according to a structured questionnaire, which was pre-tested in three pilot interviews. The SDR revealed that in Switzerland the collection of standardized outcome measurements are limited to few institutions. Few initiatives are targeting hospitals to improve value for patients or assessing costs. As yet, no recognized outcome-based payment mechanism is available. According to the interviewees, the healthcare system is well funded and efficient, but VBHC could help to improve the system and reduce waste. In spite of this, VBHC is being explored in some areas in Switzerland but it is in its early stages. Main hurdles include low impetus to change, non-standardized patient pathway, no political commitment and inability to use AI in demonstrating value. In contrast, drivers for VBHC could include a highly effective health system, willingness of authorities to new concepts and trained professionals. The present work indicated that knowledge around VBHC and implementation of VBHC programs in the Swiss healthcare system is developing. In order to progress, behavioural change (quantity to quality) is key for the transition to VBHC. Additionally, evidence from real-world studies, pilot programs around VBHC components (such as patient related-outcome measures and costs) at hospitals and the usage of new technology to manage data are needed.

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