PNS31 Transition to Value Based Healthcare in Latin America: A Situation Analysis

Abstract

Value-based healthcare (VBHC) shifts the paradigm from a supply-driven model to a patient-centered one, enabling decision makers to make the best use of finite resources while achieving improved outcomes. In this study we sought to assess the status of 5 Latin American countries as to VBHC indicators. Regulations, policies, assessment reports and other publicly available documentation were reviewed in 5 countries: Argentina, Brazil, Chile, Colombia and Mexico, in order to establish countries alignment with 6 VBHC domains: Enabling policies, integrated healthcare, patient-centered outcome measurements, alternative payment models, IT infrastructure and stakeholder engagement. Enabling policies such as universal healthcare coverage and the presence of HTA bodies independent from payers/providers were found in all countries (binding power of HTA bodies’ decisions varies across countries). Regarding integrated healthcare, it is worth to remark Colombia’s recent health reforms, which are shifting the paradigm towards integrated care delivery. Health data are heterogeneously collected across countries due to fragmented healthcare systems (especially in Argentina and Mexico). Brazil and Colombia have the strongest health information systems in the region; however, outcome data availability is scarce in all countries. No formal stakeholder training in VBHC was found in any of the countries. Finally, capitation payments seem to be the mainstream in the region, although payers in all countries report outcome-based and bundled payment initiatives. Nationwide P4P and bundled payment policies were only found in Chile. By successfully implementing VBHC, countries can achieve the quadruple aim of lowering costs, improve outcomes, better patient experience and improve the experience of providing care. This review shows that although no country has achieved a complete and successful transition to VBHC, advancements can be seen in individual domains in all countries.